| Jessica Lagoo, RD | |
|
3584 W 9000 S Ste 304, West Jordan, UT 84088 | |
| (801) 601-4423 | |
| (801) 601-4422 |
| Full Name | Jessica Lagoo |
|---|---|
| Gender | Female |
| Speciality | Registered Dietitian Or Nutrition Professional |
| Experience | 5 Years |
| Location | 3584 W 9000 S Ste 304, West Jordan, Utah |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396401980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 12427442-4901 (Utah) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Catholic Health Initiatives Colorado | 8022927342 | 972 |
| Provider Name | Physician Group Of Utah Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1477676930 PECOS PAC ID: 8022032234 Enrollment ID: O20060113000886 |
| Provider Name | Catholic Health Initiatives Colorado |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1942903562 PECOS PAC ID: 8022927342 Enrollment ID: O20230615001995 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Lagoo, RD Po Box 800022, Kansas City, MO 64180-0022 Ph: () - | Jessica Lagoo, RD 3584 W 9000 S Ste 304, West Jordan, UT 84088 Ph: (801) 601-4423 |
Katie Bastian, MDA, RDN, SNS Dietitian Medicare: Not Enrolled in Medicare Practice Location: 7905 S Redwood Rd, West Jordan, UT 84088 Phone: 801-567-8602 | |
Yvette Henderson, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3580 W 9000 S, West Jordan, UT 84088 Phone: 801-964-3855 | |
Shandon James Pendleton, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3580 W 9000 S, West Jordan, UT 84088 Phone: 801-562-4269 | |
Brittny Lynne Bird, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1389 W 9000 S, West Jordan, UT 84088 Phone: 801-380-1834 | |
Ariel Lynn Fry, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3584 W 9000 S, Suite 304, West Jordan, UT 84088 Phone: 801-601-4423 Fax: 801-601-4422 | |
Maria Manuela Herrera Naranjo, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3283 W Jordan Line Pkwy Apt 154, West Jordan, UT 84088 Phone: 385-335-3211 |