Active NPI
Rod W Jeppsen, LPC
- Professional Counselor
- Sandy, UT
National Provider Identifier
1366603409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 48935846004
- Practice address
- 9500 S 500 W
Suite 209
Sandy, UT 84070-2574 - Phone
- (801) 598-3332
- NPI assigned
- Jun 20, 2008
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 48935846004 | UT | Primary |
Addresses
Primary practice location
9500 S 500 W
Suite 209
Sandy, UT 84070-2574
Mailing address
9500 S 500 W
Suite 209
Sandy, UT 84070-2574
Phone (801) 598-3332
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48935846004 | UT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Addiction Resource Center for Healing | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Sandy, UT
- NPI 1013149251
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213920000000",
"number": "1366603409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9500 S 500 W",
"address_2": "SUITE 209",
"city": "SANDY",
"state": "UT",
"postal_code": "840702574",
"telephone_number": "801-598-3332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 S 500 W",
"address_2": "SUITE 209",
"city": "SANDY",
"state": "UT",
"postal_code": "840702574",
"telephone_number": "801-598-3332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEPPSEN",
"first_name": "ROD",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-20",
"last_updated": "2008-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "UT",
"license": "48935846004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.