Individual provider Active NPI

Liane Beverly Root

  • Nurse Practitioner
  • West Jordan, UT
National Provider Identifier
1336743046
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8269312-4405 Issued in UT
Practice address
7366 S Brittany Town Dr
West Jordan, UT 84084-4609
Phone
(801) 889-6063
NPI assigned
Nov 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8269312-4405 UT Primary

Addresses

Primary practice location

7366 S Brittany Town Dr
West Jordan, UT 84084-4609

Mailing address

7366 S Brittany Town Dr
West Jordan, UT 84084-4609
Phone (801) 889-6063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8269312-4405UTMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1336743046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7366 S BRITTANY TOWN DR",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840844609",
            "telephone_number": "801-889-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7366 S BRITTANY TOWN DR",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840844609",
            "telephone_number": "801-889-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "LIANE",
        "middle_name": "BEVERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "8269312-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

Verify at the official NPI Registry.