Individual provider Active NPI

Holly Ziegenhorn

  • Social Worker
  • Salt Lake City, UT
National Provider Identifier
1124730635
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6647563-3503 Issued in UT
Practice address
780 S Guardsman Way
Salt Lake City, UT 84108-1374
Phone
(888) 949-4864
NPI assigned
Dec 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Community Health Worker 172V00000X
Social Worker 104100000X 6647563-3503 UT Primary

Addresses

Primary practice location

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

Mailing address

4460 S Highland Dr
Salt Lake City, UT 84124-3543
Phone (888) 949-4864

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
6647563-3503UTMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1124730635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 S HIGHLAND DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841243543",
            "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": "888-949-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEGENHORN",
        "first_name": "HOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "6647563-3503",
            "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 Jul 5, 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.