Individual provider Active NPI

Jacob Daniel Barnes, FNP-C

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1356075931
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12740285-4405 Issued in UT
Practice address
82 S 1100 E Ste 403
Salt Lake City, UT 84102-1892
Phone
(801) 505-5299
NPI assigned
Jul 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12740285-4405 UT Primary

Addresses

Primary practice location

82 S 1100 E Ste 403
Salt Lake City, UT 84102-1892

Mailing address

566 E 3300 S Unit 805
Salt Lake City, UT 84106-4735
Phone (765) 480-9117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230302000685 IN Practitioner - Nurse Practitioner 2860865490 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physician Network Urgent Care LLCGroup PAC ID 1052819869, 80 clinicians
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

8177 Clearvista Pkwy
Suite 100
Indianapolis, IN 46256-1662
Phone (317) 621-7800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12740285-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Mar 1, 2023 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Mar 1, 2023 Accepting new patients
Community Physician Network Urgent Care LLC CurrentSince Jul 6, 2025 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

8177 Clearvista Pkwy
#100
Indianapolis, IN 46256
Phone (317) 621-7800

Interoperability endpoints

  • Direct secure messaging: jbarnes445696@ecommunitydirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1356075931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "566 E 3300 S UNIT 805",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841064735",
            "telephone_number": "765-480-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 S 1100 E STE 403",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021892",
            "telephone_number": "801-505-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "JACOB",
        "middle_name": "DANIEL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "12740285-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.