Mary Jane Cumberland, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2177194405 Issued in UT

Practice address

1020 S Main St
Salt Lake City, UT 84101-3176

Phone

(801) 539-7000

Fax

(801) 539-7050

NPI assigned

Jan 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Other names 1

• Ms. Jane Cumberland Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Valley Behavioral Health Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Valley City, UT
  • NPI 1932166980

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1396715504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 Q ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841033950",
            "telephone_number": "801-531-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S MAIN ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841013176",
            "telephone_number": "801-539-7000",
            "fax_number": "801-539-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMBERLAND",
        "first_name": "MARY",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "2177194405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "2177194405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RCAR",
            "identifier": "003104021",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U002--DESERET MUTUAL",
            "identifier": "857364",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ICAR",
            "identifier": "Q39422",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U006",
            "identifier": "107029319101",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U009",
            "identifier": "94293834884101A008",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U003",
            "identifier": "942938348MJC",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "CUMBERLAND",
            "prefix": "MS.",
            "credential": "APRN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Braxton Tate Cullum
• Danniel Worthen Cullumber, LCSW
• Zachary Jerome Culp, MD
• Alberto Cumba
• Tierra Bree Cumba
• Amanda Cummings, PA-C
• Anne Cummings
• David Bruce Cummings
• Destinee D Cummings
• Julia Anna Cummings

• All providers in Salt Lake City, UT
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.

Verify at the official NPI Registry.