Active NPI
Samuel Craig Fetzer
- Social Worker
- Cedar City, UT
National Provider Identifier
1386917649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 33 N 300 E
Cedar City, UT 84720-2620 - Phone
- (435) 586-6654
- NPI assigned
- Feb 17, 2012
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
33 N 300 E
Cedar City, UT 84720-2620
Mailing address
1896 North 1600 North Access Rd
Cedar City, UT 84721
Phone (435) 668-2796
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329436800000",
"number": "1386917649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1896 NORTH 1600 NORTH ACCESS RD",
"city": "CEDAR CITY",
"state": "UT",
"postal_code": "84721",
"telephone_number": "435-668-2796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 N 300 E",
"city": "CEDAR CITY",
"state": "UT",
"postal_code": "847202620",
"telephone_number": "435-586-6654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FETZER",
"first_name": "SAMUEL",
"middle_name": "CRAIG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-17",
"last_updated": "2012-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.