Active NPI
Jean F Botha, MD
- Surgery Physician
- Murray, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 12742339-1205
- Practice address
- 5171 S Cottonwood St Ste 210
Murray, UT 84107-5718 - Phone
- (801) 507-3380
- Fax
- (801) 507-8343
- NPI assigned
- Apr 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 12742339-1205 | UT | Primary |
| Transplant Surgery Physician | 204F00000X | 12742339-1205 | UT | |
| Transplant Surgery Physician | 204F00000X | 22313 | NE |
Addresses
Primary practice location
5171 S Cottonwood St Ste 210
Murray, UT 84107-5718
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 507-3380
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47078557580 | Medicaid | NE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | JBOTHA814503@DIRECT.MED.UTAH.EDU | Direct | University of Utah |
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguest_Service | Other | Bluemark LLC / Office Ally |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12742339-1205 | UT | MD | Transplant Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Transplant Surgery | Current | Accepting new patients |
Locations
5171 S Cottonwood St
Ste 210
Salt Lake City, UT 84107
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
81 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 662-5700
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba IMED Physicians Billing
- Multi-Specialty Clinic/Center
- Murray, UT
- NPI 1629260880
Transplant Surgery
-
dba IMED Utah Heart - Monticello
- Multi-Specialty Clinic/Center
- Monticello, UT
- NPI 1043444805
-
dba St George Adolescent Partial Hospitalization
- Psychiatry Physician
- St George, UT
- NPI 1023843844
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Intermountain Health Intermountain Medical Center
- General Acute Care Hospital
- Murray, UT
- NPI 1043220650
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789948800000",
"number": "1982661344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128",
"telephone_number": "801-507-3380",
"fax_number": "801-507-8343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5171 S COTTONWOOD ST STE 210",
"city": "MURRAY",
"state": "UT",
"postal_code": "841075718",
"telephone_number": "801-507-3380",
"fax_number": "801-507-8343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOTHA",
"first_name": "JEAN",
"middle_name": "F",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-28",
"last_updated": "2026-09-21",
"certification_date": "2026-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "UT",
"license": "12742339-1205",
"primary": true
},
{
"code": "204F00000X",
"taxonomy_group": "",
"desc": "Transplant Surgery",
"state": "UT",
"license": "12742339-1205",
"primary": false
},
{
"code": "204F00000X",
"taxonomy_group": "",
"desc": "Transplant Surgery",
"state": "NE",
"license": "22313",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47078557580",
"state": "NE"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "JBOTHA814503@DIRECT.MED.UTAH.EDU",
"affiliation": "Y",
"affiliationName": "University of Utah",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320100",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC / Office Ally",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.