MR. JUSTIN RICHARD DEGOOYER (NPI# 1578172904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578172904 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN RICHARD DEGOOYER |
| Credential | APRN |
| Practice Address |
4401 Harrison Blvd Ogden UT 84403-3195 |
| Mailing Address |
1333 Fox Pointe Dr Kaysville UT 84037-4060 |
| Practice Telephone | 3852592714 |
| Mailing Telephone | 3852592714 |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2020-08-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WC0200X |
Registered Nurse Specialization: Critical Care Medicine |
9421639-3102 | UT | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
9421639-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4401 HARRISON BLVD |
| City | OGDEN |
| State | UT |
| Zip Code | 84403-3195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538142922 | Paul S Thorpe | Pathology | 4401 Harrison Blvd, Ogden, UT 84403-3195 | 2005-11-21 |
| 1730707795 | Caitlin Karissa Taggart | Dietitian, Registered | 4401 Harrison Blvd, Ogden, UT 84403-3195 | 2020-07-07 |
| 1760006324 | Rachel Michelle Wright | Registered Nurse | 4401 Harrison Blvd, Ogden, UT 84403-3195 | 2020-05-29 |
| 1528688264 | Mckenna Kelly Vance | Registered Nurse | 4401 Harrison Blvd, Ogden, UT 84403-3195 | 2020-04-22 |
| 1073133252 | Carole Lomax | Dietitian, Registered | 4401 Harrison Blvd, Ogden, UT 84403-3195 | 2020-04-17 |
| 1821618000 | Tami Greaves Halford | Registered Nurse | 4401 Harrison Blvd, Ogden, UT 84403-3195 | 2020-04-17 |
| 1356988695 | Elizabeth A Hafen | Speech-Language Pathologist | 4401 Harrison Blvd, Ogden, UT 84403-3195 | 2019-12-05 |
| 1902441835 | Courtney Mcdonald | Occupational Therapist | 4401 Harrison Blvd, Ogden, UT 84403-3195 | 2019-11-14 |
| 1275178238 | Philip Hahn Gainer | Occupational Therapist | 4401 Harrison Blvd, Ogden, UT 84403-3195 | 2019-11-14 |
| 1972148104 | Jessica Tereese Voorhees | Physical Therapist | 4401 Harrison Blvd, Ogden, UT 84403-3195 | 2019-11-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744632 | Megan Louise Larkins | Specialist/Technologist | 4000 Brinker Ave. The Apartments., Apartment 15, Ogden, UT 84403 | 2020-09-11 |
| 1154959062 | Joshua Clifford Hansen | Student in an Organized Health Care Education/Training Program | 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 | 2020-03-28 |
| 1346895935 | Positional Release Therapy Institute LLC | Specialist/Technologist | 1702 E. 5600 S., Ogden, UT 84403 | 2019-08-09 |
| 1841842077 | Braken Wooden | Chiropractor | 1893 Skyline Dr., Suite 204, South Ogden, UT 84403 | 2019-07-09 |
| 1023670569 | Wasatch Advanced Dental Care LLC | Dentist | 3590 Harrison Blvd Suite #1, Ogden, UT 84403 | 2019-07-05 |
| 1194237636 | Marci Niemeyer | Physician Assistant | 5929 Fashion Point Dr Ste 101, South Ogden, UT 84403 | 2017-10-24 |
| 1578081949 | Stephanie Jensen | Specialist/Technologist | 1473 36th Street, Ogden, UT 84403 | 2017-09-06 |
| 1891213385 | Forrest Sutherland | Specialist/Technologist | 1075 E 41st St., Ogden, UT 84403 | 2017-09-05 |
| 1184159022 | Nicole Lee Van Tassell | In Home Supportive Care | 1496 East 5600 South, Unit 6, Ogden, UT 84403 | 2017-04-28 |
| 1265889166 | Modern Dental Professionals Ut, PC | Dentist | 5974 S. Fashion Pointe Drive, Suite 210, South Ogden, UT 84403 | 2016-05-20 |
| Find all providers in zip 84403 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306473368 | Stephanie Michaele Turner | Nurse Practitioner | 865 Maple St, Ogden, UT 84403-1923 | 2020-03-26 |
| 1114579596 | James Edward Fenton Jr. | Nurse Practitioner | 2351 Grant Ave Ste 201, Ogden, UT 84401 | 2019-07-15 |
| 1891205811 | Amy Lynn Hinckley | Nurse Practitioner | 4933 S 1500 W Ste 200, Ogden, UT 84405-7738 | 2017-10-04 |
| 1619426376 | Angela Weil | Nurse Practitioner | 2540 Washington Blvd Ste 122, Ogden, UT 84401-3112 | 2016-09-22 |
| 1235531500 | Tyson Oakey | Nurse Practitioner | 3860 Jackson Ave Ste 7, Ogden, UT 84403-1979 | 2014-09-18 |
| 1144668591 | Jordan Wyler Johnsen | Nurse Practitioner | 4387 Harrison Blvd Ste D8, Ogden, UT 84403-3267 | 2013-06-07 |
| 1275979841 | Dustin C Jasmer | Nurse Practitioner | 5315 S 500 E Ste A, Ogden, UT 84405-4772 | 2013-05-22 |
| 1740585603 | Angela Lynn Christner | Nurse Practitioner | 245 W Walnut St, Ogden, IA 50212-7705 | 2011-01-24 |
| 1558512897 | Trent Willey | Nurse Practitioner | 1447 Canyon Cove Gln Apt 29, Ogden, UT 84401-0829 | 2008-10-06 |
| 1770747941 | Mary Leslie Rohan | Nurse Practitioner | 1128 University Cir, Student Service Center 190, Ogden, UT 84408-1128 | 2008-07-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.