Individual provider Active NPI

Cheryl M Jensen, A.P.R.N.

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Salt Lake City, UT
National Provider Identifier
1285696187
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
198809-4405 Issued in UT
Practice address
2040 E. Murray Holladay Rd
Suite 222
Salt Lake City, UT 84117-5185
Phone
(801) 278-0499
Fax
(801) 278-0489
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 198809-4405 UT Primary

Addresses

Primary practice location

2040 E. Murray Holladay Rd
Suite 222
Salt Lake City, UT 84117-5185

Mailing address

11167 Sandy Gulch Rd
Sandy, UT 84094-5315
Phone (801) 619-4802

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
198809-4405UTMDPsychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Hanson PHD Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285696187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11167 SANDY GULCH RD",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840945315",
            "telephone_number": "801-619-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 E. MURRAY HOLLADAY RD",
            "address_2": "SUITE 222",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841175185",
            "telephone_number": "801-278-0499",
            "fax_number": "801-278-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "CHERYL",
        "middle_name": "M",
        "credential": "A.P.R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "UT",
            "license": "198809-4405",
            "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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.