KATIE ROUSSEAU JEANS M.D. NPI 1093151862

NPI Information

NPI: 1093151862
Provider Name: KATIE ROUSSEAU JEANS, M.D.
Classification: Internal Medicine - 207RP1001X
Entity Type: Individual

Specialization: Pulmonary Disease

Organization: INTERMOUNTAIN HEALTHCARE SERVICES, INC

PECOS Registration: Yes

Address:
5801 S FASHION BLVD STE 280
MURRAY, UT
ZIP 84107
Phone: (801) 268-5684
Get Directions

Katie Rousseau Jeans, M.D. is a pulmonary disease internal medicine in Murray, UT with 11 years of experience. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. Katie Rousseau Jeans, M.D. NPI is 1093151862. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduation Year:2013

The provider's business location address is:

5801 S FASHION BLVD STE 280
MURRAY, UT
ZIP 84107-136
Phone: (801) 268-5684

The NPI 1093151862 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/20/2013 and was last updated on 9/8/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		R4566	TEXAS	No
2	207RC0200X	Internal Medicine	Critical Care Medicine	R4566	TEXAS	No
3	207RP1001X	Internal Medicine	Pulmonary Disease	R4566	TEXAS	No
4	207RP1001X	Internal Medicine	Pulmonary Disease	12340843-1205	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	401850901	MEDICAID	TEXAS
2	401850902	MEDICAID	TEXAS
3	401850903	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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