Active NPI
Ellen Fassmann Jarvis, RPH PHARMD
- Pharmacist
- Salt Lake City, UT
National Provider Identifier
1235343310
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Oct 20, 2016.
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 145001-1701
- Practice address
- 2040 S 2300 E
Salt Lake City, UT 84108-3220 - Phone
- (801) 487-1018
- Fax
- (801) 485-2271
- NPI assigned
- May 9, 2007
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 145001-1701 | UT | Primary |
Addresses
Primary practice location
2040 S 2300 E
Salt Lake City, UT 84108-3220
Mailing address
1912 Millbrook Dr
Salt Lake City, UT 84106-3825
Phone (801) 463-9084
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 145001-1701 | UT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235343310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1912 MILLBROOK DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841063825",
"telephone_number": "801-463-9084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 S 2300 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841083220",
"telephone_number": "801-487-1018",
"fax_number": "801-485-2271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARVIS",
"first_name": "ELLEN",
"middle_name": "FASSMANN",
"name_prefix": "Dr.",
"credential": "RPH PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "145001-1701",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.