JACK EDWARD STEPHENS M.D.
NPI 1073991915
Internal Medicine in Ogden, UT

Q: What is Jack Stephens's NPI number?

The NPI number for Jack Stephens is 1073991915. It was assigned to this individual provider in the NPPES registry on May 12, 2015.

Q: What is Jack Stephens's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Stephens was last updated on June 21, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 12, 2015PECOS EnrolledAccepts Medicare Assignment

4401 HARRISON BLVD, OGDEN, UT 84403(801) 387-3709(801) 387-3725 Get Directions Write a Review

NPPES record last updated: June 21, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Jack Edward Stephens M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK EDWARD STEPHENS M.D. (NPI 1073991915) is an individual internal medicine provider in Ogden, Utah, licensed in Utah (10476493-1205) and active in the NPI registry since May 2015. He is enrolled in Medicare PECOS, is affiliated with Mckay-dee Hospital, and is a graduate of Albany Medical College Of Union University (2015).

NPPES Registry Identity

NPI1073991915

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameJACK EDWARD STEPHENSCredential: M.D.

Location Address4401 HARRISON BLVDOgden, UT 84403

Mailing Address6140 Sharon CirOgden, UT 84403-5008 · (435) 901-2735

Phone(801) 387-3709

Fax(801) 387-3725

Sole ProprietorNo

Medical School CMSAlbany Medical College Of Union UniversityGraduated 2015

Enumeration DateMay 12, 2015

Last NPPES UpdateJune 21, 2018

✔ NPI 1073991915 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in UT · 10476493-1205✔ Licensed in UT · 10476493-8905✔ Licensed in AZ · R74955

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

4401 HARRISON BLVD, Ogden, UT 84403

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jack Edward Stephens M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163782855

PECOS Enrollment IDI20190103001338

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jack Stephens reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ihc Health Services Inc

Same address

Multi-Specialty

4401 HARRISON BLVD
Ogden, UT 84403

Reassigned Medicare billing, Utah enrollment
Also billed through NPI 1154888907 (Utah)
1,729 clinicians in this Medicare group

NPI 1811917057 (801) 387-2800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

100 services99 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

40 services40 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mckay-Dee Hospital

Acute Care Hospitals · Ogden, UT

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number460004

Location4401 Harrison BoulevardOgden, UT 84403 · Weber County

Emergency services Birthing friendly

Intermountain Health Layton Hospital

Acute Care Hospitals · Layton, UT

OwnershipVoluntary non-profit - Private

CMS Certification Number460061

Location201 West Layton ParkwayLayton, UT 84041 · Davis County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$125.70 typical visit price

range $54.34 – $166.03

Typical copayment $31.42 (range $13.58 – $41.50)

Most-billed visit code 99204

Established Patient

$96.35 typical visit price

range $17.23 – $135.20

Typical copayment $24.08 (range $4.30 – $33.80)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers21 claims21 services$17.22 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

4 suppliers39 claims40 services$97.97 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier11 claims12 services$38.23 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MIKHAIL SHIPOTKO MD

Hospitalist