Individual provider Active NPI

Jordan R Rentmeister, DNP/FNP

  • Family Nurse Practitioner
  • Draper, UT
National Provider Identifier
1952011306
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10646913-4405 Issued in UT
Practice address
12176 S 1000 E Ste 4
Draper, UT 84020-3221
Phone
(800) 640-3451
Fax
(385) 287-1900
NPI assigned
Nov 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10646913-4405 UT Primary
Nurse Practitioner 363L00000X 79646 ID

Addresses

Primary practice location

12176 S 1000 E Ste 4
Draper, UT 84020-3221

Mailing address

PO Box 1200
Pleasant Grove, UT 84062-1200
Phone (800) 640-3451

Other practice location 1

2065 E 17th St Ste A
Idaho Falls, ID 83404-8042
Phone (800) 640-3451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, UT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240717003612 ID Practitioner - Nurse Practitioner 3971048638 Reassigns benefits to 1 organization
I20240718000306 UT Practitioner - Nurse Practitioner 3971048638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spencer J Hardenbrook MD PCGroup PAC ID 2062733546, 93 clinicians

Practice addresses (Care Compare)

12176 S 1000
Draper, UT 84020-9734
Phone (800) 640-3451

2065 E 17TH St
Suite a
Idaho Falls, ID 83404-8042
Phone (800) 640-3451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10646913-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer J Hardenbrook MD PC CurrentSince Jul 1, 2024 Accepting new patients
Harold N Gooch MD LLC Current Accepting new patients

Locations

2065 E 17th St
Ste A
Idaho Falls, ID 83404
Phone (208) 522-3301

2065 E 17th St
Idaho Falls, ID 83404
Phone (208) 521-2607

12176 S 1000 E
Ste 4
Draper, UT 84020
Phone (801) 572-3750

12176 S 1000 E
Draper, UT 84020
Phone (801) 523-3023

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1952011306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1200",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840621200",
            "telephone_number": "800-640-3451",
            "fax_number": "385-287-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12176 S 1000 E STE 4",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840203221",
            "telephone_number": "800-640-3451",
            "fax_number": "385-287-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2065 E 17th St Ste A",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834048042",
            "country_code": "US",
            "telephone_number": "800-640-3451",
            "fax_number": "385-287-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENTMEISTER",
        "first_name": "JORDAN",
        "middle_name": "R",
        "credential": "DNP/FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-28",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "10646913-4405",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "79646",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

Verify at the official NPI Registry.