Individual provider Active NPI

Kobe Jeppesen

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1205528262
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14223866-3502 Issued in UT
Practice address
275 E South Temple Ste 103
Salt Lake City, UT 84111-1323
Phone
(801) 382-7265
NPI assigned
May 25, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 14223866-3502 UT Primary

Addresses

Primary practice location

275 E South Temple Ste 103
Salt Lake City, UT 84111-1323

Mailing address

275 E South Temple Ste 103
Salt Lake City, UT 84111-1323
Phone (801) 382-7265

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
14223866-3502UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1205528262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 E SOUTH TEMPLE STE 103",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841111323",
            "telephone_number": "801-382-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 E SOUTH TEMPLE STE 103",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841111323",
            "telephone_number": "801-382-7265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPPESEN",
        "first_name": "KOBE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-25",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "14223866-3502",
            "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 Sep 4, 2025; 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.