Individual provider Active NPI

Lewis B Hancock, PH.D.

  • Social Worker
  • Salt Lake City, UT
National Provider Identifier
1245339621
Registry record updated Nov 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
83-114587-3501 Issued in UT
Practice address
3229 S Melbourne St
Salt Lake City, UT 84106-3912
Phone
(801) 487-9000
Fax
(801) 487-9696
NPI assigned
Sep 21, 2006
Last updated
Nov 15, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 83-114587-3501 UT Primary

Addresses

Primary practice location

3229 S Melbourne St
Salt Lake City, UT 84106-3912

Mailing address

3229 S Melbourne St
Salt Lake City, UT 84106-3912
Phone (801) 487-9000

Other identifiers 4

IdentifierTypeStateIssuer
12828OtherUTPEHP
195567OtherUTVALUE OPTIONS
107009352101OtherUTIHC
109961000OtherUTMAGELLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130528000081 UT Practitioner - Clinical Social Worker 5496993750 Practice locations: Salt Lake City, UT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3229 S Melbourne St
Salt Lake City, UT 84106-3912
Phone (801) 487-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
83-114587-3501UTMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510704000000",
    "number": "1245339621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3229 S MELBOURNE ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063912",
            "telephone_number": "801-487-9000",
            "fax_number": "801-487-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3229 S MELBOURNE ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063912",
            "telephone_number": "801-487-9000",
            "fax_number": "801-487-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "LEWIS",
        "middle_name": "B",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2017-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "83-114587-3501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "12828",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "195567",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC",
            "identifier": "107009352101",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "109961000",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.