Active NPI
Shawnery Mathis
- Marriage & Family Therapist
- West Valley, UT
National Provider Identifier
1164486080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 5913587-3904
- Practice address
- 3600 Market St
Suite 200
West Valley, UT 84119-3783 - Phone
- (801) 394-2096
- NPI assigned
- Apr 17, 2006
- Last updated
- Mar 3, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 5913587-3904 | UT | Primary |
Addresses
Primary practice location
3600 Market St
Suite 200
West Valley, UT 84119-3783
Mailing address
381 N Washington Blvd
#C304
Ogden, UT 84404-3913
Phone (801) 394-2096
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 |
|---|---|---|---|
| 5913587-3904 | UT | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267574400000",
"number": "1164486080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "381 N WASHINGTON BLVD",
"address_2": "#C304",
"city": "OGDEN",
"state": "UT",
"postal_code": "844043913",
"telephone_number": "801-394-2096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 MARKET ST",
"address_2": "SUITE 200",
"city": "WEST VALLEY",
"state": "UT",
"postal_code": "841193783",
"telephone_number": "801-394-2096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "SHAWNERY",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-17",
"last_updated": "2010-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "UT",
"license": "5913587-3904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Valley, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.