Individual provider Active NPI

Anna Cathryn Eastman, SSW

  • Social Worker
  • Salt Lake City, UT
National Provider Identifier
1386138758
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
12716936-3503 Issued in UT
Practice address
344 E 100 S
Salt Lake City, UT 84111-1700
Phone
(801) 322-3222
NPI assigned
Jun 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 12716936-3503 UT Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

344 E 100 S
Salt Lake City, UT 84111-1700

Mailing address

660 S 200 E Ste 250
Salt Lake City, UT 84111-3846
Phone (801) 359-2256

Other names 1

  • Anna Cathryn Fuller Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
12716936-3503UTMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1386138758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S 200 E STE 250",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841113846",
            "telephone_number": "801-359-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 E 100 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841111700",
            "telephone_number": "801-322-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTMAN",
        "first_name": "ANNA",
        "middle_name": "CATHRYN",
        "name_prefix": "Miss",
        "credential": "SSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "12716936-3503",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "FULLER",
            "middle_name": "CATHRYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.