Jaime Alden Booz

Individual provider Active NPI Speech-Language Pathologist · Midvale, UT

NPI 1083245690 · NPPES record last updated Aug 16, 2023

Key facts

NPI
1083245690
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
10231059-4102 (UT)
Practice address
1012 W Jordan River Blvd
Midvale, UT 84047-4865
Phone
(801) 647-5691
NPI assigned
Feb 1, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in UT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200401003159 UT Practitioner - Qualified Speech Language Pathologist 2567891112 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 10231059-4102 UT Yes

Addresses

Primary practice location

1012 W Jordan River Blvd
Midvale, UT 84047-4865

Mailing address

655 E 3065 S
South Salt Lake, UT 84106-1350
Phone (801) 647-5691

Other practice location 1

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 647-5691

Other names

  • Jaime Alden Booz Other name

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address jbooz412632@direct.med.utah.edu Direct University of Utah

Other providers in Midvale, UT

All providers in Midvale, UT · Speech-Language Pathologist in Utah

Sources for this page

Verify at the official NPI Registry.