Individual provider Active NPI

Jaycee C Mitchell, CNA

  • Nurse's Aide
  • Pleasant Grove, UT
National Provider Identifier
1104536937
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
UT011304201619 Issued in UT
Practice address
867 S 800 W
Pleasant Grove, UT 84062-4505
Phone
(801) 785-9019
NPI assigned
Dec 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X UT011304201619 UT Primary

Addresses

Primary practice location

867 S 800 W
Pleasant Grove, UT 84062-4505

Mailing address

867 S 800 W
Pleasant Grove, UT 84062-4505
Phone (801) 785-9019

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
UT011304201619UTMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1104536937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "867 S 800 W",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840624505",
            "telephone_number": "801-785-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 S 800 W",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840624505",
            "telephone_number": "801-785-9019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JAYCEE",
        "middle_name": "C",
        "credential": "CNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "UT",
            "license": "UT011304201619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Grove, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.