Individual provider Active NPI

Jessica Deckart, APRN

  • Acute Care Nurse Practitioner
  • South Jordan, UT
National Provider Identifier
1952035750
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
8752080-4405 Issued in UT
Practice address
3556 W 9800 S Ste 101
South Jordan, UT 84095-3221
Phone
(801) 567-9780
Fax
(801) 567-9826
NPI assigned
Jul 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 8752080-4405 UT Primary

Addresses

Primary practice location

3556 W 9800 S Ste 101
South Jordan, UT 84095-3221

Mailing address

752 W Stephens View Way
Draper, UT 84020-8422
Phone (801) 918-3438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20221215001001 UT Practitioner - Nurse Practitioner 1355710203 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
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

5121 S Cottonwood St
Murray, UT 84107-5701
Phone (801) 507-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8752080-4405UTMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince May 9, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince May 9, 2023 Accepting new patients

Locations

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1657843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1952035750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 W STEPHENS VIEW WAY",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208422",
            "telephone_number": "801-918-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3556 W 9800 S STE 101",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840953221",
            "telephone_number": "801-567-9780",
            "fax_number": "801-567-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKART",
        "first_name": "JESSICA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-15",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "8752080-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

Verify at the official NPI Registry.