DR. JACOB DOUGLAS ANDERSON DNP NPI 1316329220

NPI Information

  • NPI: 1316329220
  • Provider Name: DR. JACOB DOUGLAS ANDERSON, DNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 630 E 1400 N STE 150
    LOGAN, UT
    ZIP 84341
  • Phone: (435) 915-4465

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NPI Details

DR. Jacob Douglas Anderson, DNP is a family nurse practitioner in Logan, UT with 11 years of experience. DR. Jacob Douglas Anderson, DNP NPI is 1316329220. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduation Year:2015

The provider's business location address is:

630 E 1400 N STE 150
LOGAN, UT
ZIP 84341-549
Phone: (435) 915-4465
Fax: (435) 787-8509

The NPI 1316329220 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen (HCPCS:87635)
  • Automated urinalysis test (HCPCS:81003)
  • Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) (HCPCS:87811)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)

The enumeration date for this NPI number is 6/26/2015 and was last updated on 7/8/2020.

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
1261QP2300XClinic/CenterPrimary CareNo
2261QU0200XClinic/CenterUrgent CareNo
3261QX0100XClinic/CenterOccupational MedicineNo
4363LF0000XNurse PractitionerFamily7942683-4405UTAHYes

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 Other Provider Identifier Issuer
11205300407OTHERIDAHONPI
2833011825OTHERIDAHOSTATE

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: 11/21/2025

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