John David Malouf, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

317131-1204 Issued in UT

Practice address

1219 N 400 E
Logan, UT 84341-2321

Phone

(435) 565-6043

Fax

(435) 220-2030

NPI assigned

May 12, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2010

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)

Hospital & facility affiliations

• Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group NPD
• Living Tree Medical Group

  • Family Medicine Physician
  • Logan, UT
  • NPI 1639754583
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Gastroenterology Physician
  • Murray, UT
  • NPI 1578082772
  NPD

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

• Ihc Health Services Inc

  • General Acute Care Hospital
  • Logan, UT
  • NPI 1831108497
  Care Compare affiliation

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1992097612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 N 920 E",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843415806",
            "telephone_number": "435-557-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 N 400 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412321",
            "telephone_number": "435-565-6043",
            "fax_number": "435-220-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALOUF",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-12",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101018972",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "317131-1204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992097612",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "livingtreemedical.com",
            "affiliation": "Y",
            "endpointDescription": "website",
            "affiliationName": "Living Tree Medical Group",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "living tree medical",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "main website",
            "address_1": "1219 N 400 E",
            "city": "Logan",
            "state": "UT",
            "country_code": "US",
            "postal_code": "843412321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aspyn Madsen
• Jeff Madsen, R. PH.
• Melissa Megan Majors
• Jessica Mallory
• James T Malouf, M.D.
• Steven Christopher Mance III, LAT, ATC
• Jared R Manning, MD
• Hyrum Marchant
• Hazel Mariano, FNP, PMHNP
• Kali Leanne Markle, AUD

• Family Medicine Physician in Logan, UT
• Providers in Logan, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.

Verify at the official NPI Registry.