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JESSIE HADERLIE
NPI 1699509257
Registered Nurse - Psychiatric/Mental Health in West Jordan, UT

Active since August 27, 2024PECOS EnrolledAccepts Medicare Assignment
5573 W BLUEVAIL CT, WEST JORDAN, UT 84081(801) 419-9365 Get Directions Write a Review

NPPES record last updated: November 20, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Nov 20, 2025, Sep 24, 2024 (2 updates tracked since 2024).

About Jessie Haderlie NPPES

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

JESSIE HADERLIE (NPI 1699509257) is an individual psychiatric/mental health provider in West Jordan, Utah, licensed in Utah (11767125-4405) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1699509257
Entity TypeIndividualFemale
Primary Taxonomy163WP0808X
Provider Legal NameJESSIE HADERLIE
Location Address5573 W BLUEVAIL CTWest Jordan, UT 84081-5226
Mailing Address5573 W Bluevail CtWest Jordan, UT 84081-5226 · (801) 419-9365
Phone(801) 419-9365
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 27, 2024
Last NPPES UpdateNovember 20, 20252 updates tracked since enumeration
NPPES CertifiedNovember 20, 2025
✔ NPI 1699509257 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRegistered Nurse · Psychiatric/Mental HealthNursing Service Providers
Taxonomy Code163WP0808X
License✔ Licensed in UT · 11767125-4405
Also ListedRegistered Nurse · Psychiatric/Mental Health, AdultTaxonomy 163WP0809X · License 11767125-3102 (UT)
5573 W BLUEVAIL CT, West Jordan, UT 84081
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jessie Haderlie 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 ID9436635075
PECOS Enrollment IDI20260113002866
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.

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 Jessie Haderlie's NPI number?

The NPI number for Jessie Haderlie is 1699509257. It was assigned to this individual provider in the NPPES registry on August 27, 2024.

Where is Jessie Haderlie located?

Jessie Haderlie practices at 5573 W Bluevail Ct, West Jordan, UT 84081. The listed phone number is (801) 419-9365.

What is Jessie Haderlie's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Psychiatric/Mental Health, with taxonomy code 163WP0808X.

Is Jessie Haderlie enrolled in Medicare?

Yes. Jessie Haderlie is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jessie Haderlie was last updated on November 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.