Individual provider Active NPI

Liam Higgins

  • Community Health Worker
  • Salt Lake City, UT
National Provider Identifier
1104601228
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
780 S Guardsman Way
Salt Lake City, UT 84108-1374
Phone
(801) 581-0194
NPI assigned
Aug 28, 2023
Sex
Male
Sole proprietor
No

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X UT Primary

Addresses

NPPES NPI Registry

Primary practice location

780 S Guardsman Way
Salt Lake City, UT 84108-1374

Mailing address

4460 S Highland Dr Ste 120
Salt Lake City, UT 84124-3550
Phone (888) 949-4864

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 28, 2023.

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1104601228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 S HIGHLAND DR STE 120",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841243550",
            "telephone_number": "888-949-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 S GUARDSMAN WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081374",
            "telephone_number": "801-581-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINS",
        "first_name": "LIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.