Individual provider Active NPI

Freida Johnson-Allen, APRN

  • Adult Health Nurse Practitioner
  • SLC, UT
National Provider Identifier
1063697902
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
213057-4405 Issued in UT
Practice address
4568 Highland Dr
Suite 290
SLC, UT 84117-4263
Phone
(801) 274-6127
Fax
(801) 274-6129
NPI assigned
Jan 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 213057-4405 UT Primary

Addresses

Primary practice location

4568 Highland Dr
Suite 290
SLC, UT 84117-4263

Mailing address

4568 S. Highland Dr.
Suite 290
SLC, UT 84117
Phone (801) 274-6127

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
213057-4405UTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Demers Mental Health Past Accepting new patients
Nurse Practitioner Healthcare Associates Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1063697902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4568 S. HIGHLAND DR.",
            "address_2": "SUITE 290",
            "city": "SLC",
            "state": "UT",
            "postal_code": "84117",
            "telephone_number": "801-274-6127",
            "fax_number": "801-274-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4568 HIGHLAND DR",
            "address_2": "SUITE 290",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841174263",
            "telephone_number": "801-274-6127",
            "fax_number": "801-274-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-ALLEN",
        "first_name": "FREIDA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "UT",
            "license": "213057-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in SLC, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; 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.