LEGACY DERMATOLOGY
NPI 1376944942
Clinic/Center - Medical Specialty in Bountiful, UT
NPI Status: Active since September 14, 2014
Contact Information
320 W 500 S
SUITE 210
BOUNTIFUL, UT
ZIP 84010
Phone: (385) 312-0650
Fax: (385) 743-3333
- Organization
- Clinic/Center
- Medical Specialty
- Accepts Insurance
- CLIA Number: 46D2097163
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-14-2027
About LEGACY DERMATOLOGY
This page provides the complete NPI Profile along with additional information for Legacy Dermatology, a provider established in Bountiful, Utah operating as a Clinic/center, focusing in medical specialty . The healthcare provider is registered in the NPI registry with number 1376944942 assigned on September 2014. The practitioner's primary taxonomy code is 261QM2500X with license number 9017921-1204 (UT). The provider is registered as an organization and their NPI record was last updated 12 years ago. The authorized official of this NPI record is Dr. Jared Rex Heaton D.o. (Physician)
- NPI
- 1376944942
- Provider Name
- LEGACY DERMATOLOGY
- Entity Type
- Organization
- Location Address
- 320 W 500 S SUITE 210 BOUNTIFUL, UT 84010
- Location Phone
- (385) 312-0650
- Location Fax
- (385) 743-3333
- Mailing Address
- 1535 LAKEVIEW DR BOUNTIFUL, UT 84010
- Mailing Phone
- (435) 770-9247
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-14-2014
- Last Update Date
- 09-14-2014
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Medical Specialty
- Taxonomy Code
- 261QM2500X
- Type
- Ambulatory Health Care Facilities
- License No.
- 9017921-1204
- License State
- UT
- Taxonomy Description
- An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BridgeSpan Standard Bronze Plan - HMO
- BridgeSpan Standard Gold Plan - HMO
- BridgeSpan Standard Silver Plan - HMO
- Bronze 8000 - EPO
- Bronze Essential 9000 Deductible With 4 Copay No Deductible Office Visits - EPO
- Bronze HSA 7000 - EPO
- Gold 2300 - EPO
- Regence Standard Bronze 7500 - EPO
- Regence Standard Gold 2000 - EPO
- Regence Standard Silver 6000 - EPO
- Silver 6500 - EPO
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay Office Visits - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay Office Visits - EPO
- Healthy Premier Silver Standard - EPO
- U Health Plus Bronze - EPO
- U Health Plus Expanded Bronze Standard - EPO
- U Health Plus Gold - EPO
- U Health Plus Gold Standard - EPO
- U Health Plus Silver - EPO
- U Health Plus Silver Standard - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 46D2097163
- Facility Type
- Physician Office
- Certificate Effective Date
- December 15, 2025
- Certificate Expiration Date
- December 14, 2027
- Laboratory Director
- JARED R. HEATON
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Legacy Dermatology after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1376944942, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 78. The final step is to find the difference between that total and the next multiple of ten (80 - 78 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 78 is 80. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376944942, enumerated as an "organization" on September 14, 2014.
The provider is located at 320 W 500 S SUITE 210 BOUNTIFUL, UT 84010 and the phone number is (385) 312-0650.
Clinic/Center with taxonomy code 261QM2500X and a focus in Medical Specialty.
The provider might be accepting Accepts: BridgeSpan Health Company, Regence BlueCross. Please consult your insurance carrier or call the provider to verify.
