Individual provider Active NPI

Caleb R Jackson, FNP

  • Family Nurse Practitioner
  • Alpine, UT
National Provider Identifier
1275926149
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
347183-4405 Issued in UT
Practice address
375 S Main St
Alpine, UT 84004-2008
Phone
(801) 891-5788
NPI assigned
Mar 16, 2015
Last updated
Jan 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 347183-4405 UT Primary

Addresses

Primary practice location

375 S Main St
Alpine, UT 84004-2008

Mailing address

375 S Main St
Alpine, UT 84004-2008
Phone (801) 891-5788

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150814014420 UT Practitioner - Nurse Practitioner 2466767744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2875 Sun Dr
Twin Falls, ID 83301-8966

3 Maryland Farms
Suite 250
Brentwood, TN 37027-5053

5171 S Cottonwood St
Suite 950
Murray, UT 84107-5713

5911 S Fashion Blvd
Suite 200
Murray, UT 84107-7210

901 E 1160
Salem, UT 84653-5547

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orr Training & Therapy Services, LLC CurrentSince Oct 23, 2017 Accepting new patients
Obstetrix Medical Group of Utah, PC PastSince Jun 2, 2025 Accepting new patients

Locations

1098 W South Jordan Pkwy
Ste 101
South Jordan, UT 84095
Phone (801) 254-5800

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1275926149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 S MAIN ST",
            "city": "ALPINE",
            "state": "UT",
            "postal_code": "840042008",
            "telephone_number": "801-891-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 S MAIN ST",
            "city": "ALPINE",
            "state": "UT",
            "postal_code": "840042008",
            "telephone_number": "801-891-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CALEB",
        "middle_name": "R",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-16",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "347183-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpine, UT

Sources for this page

Verify at the official NPI Registry.