Active NPI
Nicole Lee Van Tassell
- In Home Supportive Care Agency
- Ogden, UT
National Provider Identifier
1184159022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 82-1257775
- Practice address
- 1496 East 5600 South
Unit 6
Ogden, UT 84403 - Phone
- (801) 479-7026
- Fax
- (801) 479-7134
- NPI assigned
- Apr 28, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 82-1257775 | UT | Primary |
Addresses
Primary practice location
1496 East 5600 South
Unit 6
Ogden, UT 84403
Mailing address
1496 East 5600 South
Unit 6
Ogden, UT 84403
Phone (801) 479-7026
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 |
|---|---|---|---|
| 82-1257775 | UT | MD | In Home Supportive Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493337600000",
"number": "1184159022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1496 EAST 5600 SOUTH",
"address_2": "UNIT 6",
"city": "OGDEN",
"state": "UT",
"postal_code": "84403",
"telephone_number": "801-479-7026",
"fax_number": "801-479-7134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1496 EAST 5600 SOUTH",
"address_2": "UNIT 6",
"city": "OGDEN",
"state": "UT",
"postal_code": "84403",
"telephone_number": "801-479-7026",
"fax_number": "801-479-7134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN TASSELL",
"first_name": "NICOLE",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-28",
"last_updated": "2017-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "UT",
"license": "82-1257775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.