Active NPI
Brandon Christopher Spellen, RN
- Registered Nurse
- South Jordan, UT
National Provider Identifier
1295403053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 10493809-3102
- Practice address
- 3646 W Golden Sky LN
South Jordan, UT 84009-3143 - Phone
- (617) 895-6542
- NPI assigned
- Sep 5, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 10493809-3102 | UT | Primary |
Addresses
Primary practice location
3646 W Golden Sky LN
South Jordan, UT 84009-3143
Mailing address
3646 W Golden Sky LN
South Jordan, UT 84009-3143
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10493809-3102 | UT | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630800000000",
"number": "1295403053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3646 W GOLDEN SKY LN",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840093143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3646 W GOLDEN SKY LN",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840093143",
"telephone_number": "617-895-6542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPELLEN",
"first_name": "BRANDON",
"middle_name": "CHRISTOPHER",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-05",
"last_updated": "2021-09-05",
"certification_date": "2021-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "UT",
"license": "10493809-3102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Jordan, UT
- South Valley Speech and Language, LLC
- Southridge Pediatric Dentistry
- Southwest Chiropractic, Inc.
- Southwest Oral and Facial Surgery Inc
- Michaelle Lei Spears, APRN
- Terra Spencer, CSW
- Sports Drug Testing Laboratory, LLC
- Holly Pack Squires, LMFT
- Elaine St. James, RN
- St. Mark'S South Jordan Family Practice LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.