Individual provider Active NPI

Derek Robison

  • School Social Worker
  • South Salt Lake, UT
National Provider Identifier
1174035471
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
Practice address
2500 S State St
South Salt Lake, UT 84115-3164
Phone
(801) 725-2680
NPI assigned
Oct 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X Primary

Addresses

Primary practice location

2500 S State St
South Salt Lake, UT 84115-3164

Mailing address

344 E 100 S Ste 301
Salt Lake City, UT 84111-1727
Phone (801) 428-4257

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

Practice roles

OrganizationSpecialtyStatusNew patients
Good Growth Therapy Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1174035471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 E 100 S STE 301",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841111727",
            "telephone_number": "801-428-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S STATE ST",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841153164",
            "telephone_number": "801-725-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBISON",
        "first_name": "DEREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-26",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Salt Lake, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.