I Connections Support Coordination

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

1033 Issued in UT

Legal business name

I CONNECTIONS SUPPORT COORDINATION

Practice address

1905 S 575 E
Clearfield, UT 84015-6230

Phone

(801) 728-0269

Fax

(801) 728-0269

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Daniel Harold Ibarguen, SSW

Title

Owner Support Coordinator

Phone

(801) 663-9563

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235259797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 S 575 E",
            "city": "CLEARFIELD",
            "state": "UT",
            "postal_code": "840156230",
            "telephone_number": "801-728-0269",
            "fax_number": "801-728-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 S 575 E",
            "city": "CLEARFIELD",
            "state": "UT",
            "postal_code": "840156230",
            "telephone_number": "801-728-0269",
            "fax_number": "801-728-0269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I CONNECTIONS SUPPORT COORDINATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IBARGUEN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "OWNER SUPPORT COORDINATOR",
        "authorized_official_telephone_number": "801-663-9563",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "SSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "UT",
            "license": "1033",
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "UT",
            "license": "1028",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204638051001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.