Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jaddon Trent Rogers, PA-C

Individual provider Physician Assistant · NPI 1134638810

Jaddon Trent Rogers, PA-C is a Physician Assistant in Provo, Utah. Qualified in 2017, 9 years ago. Practices with Revere Health PC, a 410-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
9
Licensed in
UT
In the registry since
2017
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1055 N 500 W Ste 111
Provo, UT 84604-3305
Phone: (801) 374-8999
Fax: (801) 429-8063
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1813 W Harvard Ave Ste 310, Roseburg, OR 97471-2756 — (541) 672-7546
  • 1790 Sun Peak Dr Ste A103, Park City, UT 84098-6625 — (435) 658-3513

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1139688 (UT)

Record details

NPI number1134638810
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 25, 2017
Last updated in NPPESApril 13, 2021
Certification dateApril 13, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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