Summit Clinical Services of Utah LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5244527-4405 Issued in UT

Legal business name

SUMMIT CLINICAL SERVICES OF UTAH LLC

Practice address

1561 W 7000 S Ste 200
West Jordan, UT 84084-3556

Phone

(801) 263-0717

Fax

(801) 266-2362

NPI assigned

Sep 30, 2014

Reactivated

Feb 26, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Chris C Hakes, LCSWNPI 1194785378

Title

Owner

Phone

(801) 414-3252

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chris Corey Hakes, LCSW

  • Clinical Social Worker
  • Tooele, UT
  • NPI 1194785378
  NPD Authorized official

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614297600000",
    "number": "1356744791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 W 7000 S STE 200",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840843556",
            "telephone_number": "801-263-0717",
            "fax_number": "801-266-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 W 7000 S STE 200",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840843556",
            "telephone_number": "801-263-0717",
            "fax_number": "801-266-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT CLINICAL SERVICES OF UTAH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-30",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "deactivation_date": "2020-06-17",
        "reactivation_date": "2021-02-26",
        "status": "A",
        "authorized_official_last_name": "HAKES",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-414-3252",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5244527-4405",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "364873-4405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Elizabeth Stutz, DMD
• Subo Health
• Helen Ann Sullivan, ACMHC
• Jaimie Sullivan
• Josh Sullivan
• Summit View Health Center, LLC
• Kim Sundstrom, DNP, APRN, PMHNP-BC
• Sunrise Family Practice LLC
• Sunrise Medical Supply Store
• Angela R Sutt, PHARMD

• Family Nurse Practitioner in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.