Individual provider Active NPI

Penny Kaye Jensen, FNP-C

  • Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1023081452
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2170254405 Issued in UT
Practice address
Salt Lake Veterans Affairs Healhcare
500 Foothill Drive
Salt Lake City, UT 84148-0001
Phone
(801) 582-1565
Fax
(801) 584-2503
NPI assigned
Feb 8, 2006
Last updated
Jan 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2170254405 UT Primary

Addresses

Primary practice location

Salt Lake Veterans Affairs Healhcare
500 Foothill Drive
Salt Lake City, UT 84148-0001

Mailing address

500 Foothill Drive
Salt Lake City VA Healthcare System
Salt Lake City, UT 84148-2415
Phone (801) 582-1565

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

State licenses

LicenseStateTypeSpecialty
2170254405UTMDNurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1023081452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 FOOTHILL DRIVE",
            "address_2": "SALT LAKE CITY VA HEALTHCARE SYSTEM",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841482415",
            "telephone_number": "801-582-1565",
            "fax_number": "801-584-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SALT LAKE VETERANS AFFAIRS HEALHCARE",
            "address_2": "500 FOOTHILL DRIVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841480001",
            "telephone_number": "801-582-1565",
            "fax_number": "801-584-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "PENNY",
        "middle_name": "KAYE",
        "name_prefix": "Dr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "2170254405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.