Active NPI
Frederick Charles Danneman III
- Professional Counselor
- Millcreek, UT
National Provider Identifier
1154928919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 8182493-6004
- Practice address
- 2059 E 3900 S
Millcreek, UT 84124-1747 - Phone
- (801) 268-2558
- NPI assigned
- Oct 5, 2020
- Last updated
- Oct 16, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 8182493-6004 | UT | Primary |
Addresses
Primary practice location
2059 E 3900 S
Millcreek, UT 84124-1747
Mailing address
609 Maple St
Clearfield, UT 84015-4033
Phone (801) 400-2578
Other practice location 1
780 S 2000 W
Syracuse, UT 84075-9602
Phone (385) 350-3039
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | dropbox | ||
| Other URL | TherapyNotes |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8182493-6004 | UT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602806400000",
"number": "1154928919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 MAPLE ST",
"city": "CLEARFIELD",
"state": "UT",
"postal_code": "840154033",
"telephone_number": "801-400-2578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2059 E 3900 S",
"city": "MILLCREEK",
"state": "UT",
"postal_code": "841241747",
"telephone_number": "801-268-2558"
}
],
"practiceLocations": [
{
"address_1": "780 S 2000 W",
"address_purpose": "LOCATION",
"city": "Syracuse",
"state": "UT",
"postal_code": "840759602",
"country_code": "US",
"telephone_number": "385-350-3039",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DANNEMAN",
"first_name": "FREDERICK",
"middle_name": "CHARLES",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-05",
"last_updated": "2020-10-16",
"certification_date": "2020-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "UT",
"license": "8182493-6004",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "dropbox",
"affiliation": "N",
"address_1": "2059 E 3900 S",
"city": "Millcreek",
"state": "UT",
"country_code": "US",
"postal_code": "841241747",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "TherapyNotes",
"affiliation": "N",
"address_1": "780 S 2000 W",
"city": "Syracuse",
"state": "UT",
"country_code": "US",
"postal_code": "840759602",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Millcreek, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.