Active NPI
Justin Jensen, B.S.
- Community Health Worker
- Brigham City, UT
National Provider Identifier
1013224104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 862 S Main St Ste 4
Brigham City, UT 84302-3389 - Phone
- (435) 723-1799
- NPI assigned
- Sep 10, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foster Care Agency | 253J00000X | |||
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
862 S Main St Ste 4
Brigham City, UT 84302-3389
Mailing address
862 S. Main Street # 4
Brigham City, UT 84302
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700438400000",
"number": "1013224104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "862 S. MAIN STREET # 4",
"city": "BRIGHAM CITY",
"state": "UT",
"postal_code": "84302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "862 S MAIN ST STE 4",
"city": "BRIGHAM CITY",
"state": "UT",
"postal_code": "843023389",
"telephone_number": "435-723-1799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "JUSTIN",
"credential": "B.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-10",
"last_updated": "2023-11-20",
"certification_date": "2023-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "253J00000X",
"taxonomy_group": "",
"desc": "Foster Care Agency",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brigham City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.