Riley D Anderson – Social Worker in Hyde Park, UT

Key facts

NPI: 1285325951
Entity type: Individual (NPI type 1)
Primary specialty: Social Worker 104100000X
License: 13396310-3502 (UT)
Practice address: 338 W 300 N
Hyde Park, UT 84318
Phone: (435) 774-4113
NPI assigned: May 15, 2023
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
13396310-3502	UT	MD	Social Worker

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Social Worker	104100000X	13396310-3502	UT	Yes

Addresses

Primary practice location

338 W 300 N
Hyde Park, UT 84318

Mailing address

338 W 300 N Ste 1
Hyde Park, UT 84318-4044
Phone (435) 774-4113

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 15, 2023.

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1285325951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 W 300 N STE 1",
            "city": "HYDE PARK",
            "state": "UT",
            "postal_code": "843184044",
            "telephone_number": "435-774-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 W 300 N",
            "city": "HYDE PARK",
            "state": "UT",
            "postal_code": "84318",
            "telephone_number": "435-774-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "RILEY",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "13396310-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyde Park, UT

All providers in Hyde Park, UT · Social Worker in Utah

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.