Jaclyn Marie Utley, OTR/L

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

3794 Issued in TN

Practice address

620 Skyline Dr
Jackson, TN 38301-3923

Phone

(731) 541-7942

NPI assigned

Aug 1, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312156800000",
    "number": "1073891578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 WOODSHIRE CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051308",
            "telephone_number": "812-568-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-541-7942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTLEY",
        "first_name": "JACLYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2011-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "TN",
            "license": "3794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• University of Tennessee
• Ashley Elaine Unzicker, PHARMD
• Angelita Upchurch
• Gina Upton
• Tara Kay Upton, RN
• Jennifer Utley, MD
• Nancy Parrish Utley, M.D.
• Binita Dipak Vadhar, MD
• Elizabeth Ann Vailes, CASE MANAGER
• Remy A Valdivia, MD

• Community Health Worker in Jackson, TN
• Providers in Jackson, TN by specialty
• Community Health Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; 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.