Active NPI
Jennie Lyn Bingham, PHD
- Psychologist
- West Jordan, UT
National Provider Identifier
1043776933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 8788382-2501
- Practice address
- 7533 S Center View CT Ste R
West Jordan, UT 84084-5526 - Phone
- (801) 380-9664
- NPI assigned
- Feb 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 8788382-2501 | UT | Primary |
Addresses
Primary practice location
7533 S Center View CT Ste R
West Jordan, UT 84084-5526
Mailing address
7533 S Center View CT Ste R
West Jordan, UT 84084-5526
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704153600000",
"number": "1043776933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7533 S CENTER VIEW CT STE R",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840845526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7533 S CENTER VIEW CT STE R",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840845526",
"telephone_number": "801-380-9664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BINGHAM",
"first_name": "JENNIE",
"middle_name": "LYN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-15",
"last_updated": "2024-01-02",
"certification_date": "2024-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "UT",
"license": "8788382-2501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.