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LEGACY DERMATOLOGY
NPI 1376944942
Clinic/Center - Medical Specialty in Bountiful, UT

Active since September 14, 2014CLIA 46D2097163 · Certificate of Compliance
320 W 500 S, SUITE 210, BOUNTIFUL, UT 84010(385) 312-0650(385) 743-3333 Get Directions Write a Review

NPPES record last updated: September 14, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Legacy Dermatology NPPES

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

LEGACY DERMATOLOGY (NPI 1376944942) is a healthcare organization registered as a medical specialty in Bountiful, Utah and active in the NPI registry since September 2014. The organization holds a CLIA Certificate of Compliance certificate valid through December 14, 2027 and lists Jared Rex Heaton, Physician, as its authorized official.

NPPES Registry Identity

NPI1376944942
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameLEGACY DERMATOLOGY
Location Address320 W 500 S, SUITE 210Bountiful, UT 84010-7218
Mailing Address1535 Lakeview DrBountiful, UT 84010-1561 · (435) 770-9247
Phone(385) 312-0650
Fax(385) 743-3333
Organization SubpartNo
Authorized OfficialJared Rex HeatonPhysician · (435) 770-9247
Enumeration DateSeptember 14, 2014
✔ NPI 1376944942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
License✔ Licensed in UT · 9017921-1204
Definition
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).
320 W 500 S, Bountiful, UT 84010
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah, University of Utah Health Plans.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 46D2097163

Legacy Dermatology · Bountiful, UT
Active · expires Dec 14, 2027
CLIA Number46D2097163
Laboratory TypePhysician Office
Certificate Effective DateDecember 15, 2025
Certificate Expiration DateDecember 14, 2027
Laboratory DirectorJared R. Heaton
Laboratory Phone(801) 797-9121
Laboratory LocationLegacy Dermatology320 W 500 S Suite 210, Bountiful, UT 84010
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legacy Dermatology's NPI number?

The NPI number for Legacy Dermatology is 1376944942. It was assigned to this organization in the NPPES registry on September 14, 2014.

Where is Legacy Dermatology located?

Legacy Dermatology is located at 320 W 500 S Suite 210, Bountiful, UT 84010. The listed phone number is (385) 312-0650.

What is Legacy Dermatology's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Does Legacy Dermatology hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 46D2097163) is associated with this NPI, valid through December 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Legacy Dermatology accept?

Health plans from BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Legacy Dermatology as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Legacy Dermatology was last updated on September 14, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.