Jessica G. Cruttenden

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

12974655-1205 Issued in UT

Practice address

1950 Circle of Hope Dr RM 1570
Salt Lake City, UT 84112-5500

Phone

(801) 581-5498

NPI assigned

Apr 23, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Stauber Former name

Medicare fee-for-service enrollment

Enrolled in UT

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1346822913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 CIRCLE OF HOPE DR RM 1570",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125500",
            "telephone_number": "801-581-5498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 CIRCLE OF HOPE DR RM 1570",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125500",
            "telephone_number": "801-581-5498"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5121 S Cottonwood St",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841075701",
            "country_code": "US",
            "telephone_number": "801-507-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUTTENDEN",
        "first_name": "JESSICA",
        "middle_name": "G.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-23",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "UT",
            "license": "12974655-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "STAUBER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaylyn Crum
• Abby N Crume, DO
• Taunica Crump, SSW
• Donald M Cruse III
• Mia Crutch
• Sergio Cruz Fajardo
• Lillian Irene Cruz Howarth
• Amy Larae Cruz, FNP
• Brittney Cruz
• Cindy Johanna Cruz, NP-BC

• Radiation Oncology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Radiation Oncology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.