NPIMap

Individual provider Active NPI

Jacob Brown, MD, PHD

  • Diagnostic Radiology Physician
  • Orem, UT
National Provider Identifier
1942526801
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
9745341-1205 Issued in UT
Practice address
560 W 800 N
Orem, UT 84057-3746
Phone
(801) 225-6246
Fax
(801) 225-1525
NPI assigned
Apr 15, 2010
Last updated
Aug 10, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 9745341-1205 UT Primary

Addresses

Primary practice location

560 W 800 N
Orem, UT 84057-3746

Mailing address

560 W 800 N
Orem, UT 84057-3746
Phone (801) 225-6246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160505001989 UT Practitioner - Diagnostic Radiology 2668603200 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Georgetown University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians
Utah Valley Radiology Associates IncGroup PAC ID 1759286990, 35 clinicians

Practice addresses (Care Compare)

1034 N 500
Uvh Psych Dept
Provo, UT 84604-3380
Phone (801) 357-7850

280 River Park Dr
Suite 120
Provo, UT 84604-5796
Phone (801) 229-2011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
16442NVMDLicensed Practical Nurse
9745341-1205UTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bakorp, L.L.C. CurrentSince Jul 1, 2016 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jul 11, 2016 Accepting new patients
Tellica Imaging, LLC CurrentSince Jan 1, 2024 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Ihc Health Services Inc CurrentSince Jul 11, 2016 Accepting new patients
St. George Radiology Inc. Diagnostic Radiology CurrentSince Jun 1, 2016 Accepting new patients
Riverwoods Urgent Care Center LC PastSince Oct 6, 2003 Accepting new patients

Locations

170 N 1100 E
American Fork, UT 84003
Phone (801) 714-6570

560 W 800 N
Orem, UT 84057
Phone (801) 701-6504

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

1055 N 300 W
Ste 104
Provo, UT 84604
Phone (801) 357-7525

250 W 300 N
#752
Roosevelt, UT 84066
Phone (435) 722-4691

1308 E 900 S
Ste C
St George, UT 84790
Phone (435) 673-2301

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15493/brand/1/csg/1/fhir/r4

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1942526801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W 800 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840573746",
            "telephone_number": "801-225-6246",
            "fax_number": "801-225-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W 800 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840573746",
            "telephone_number": "801-225-6246",
            "fax_number": "801-225-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-15",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "9745341-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

Verify at the official NPI Registry.