Active NPI
Jesse Graydon Robinson
- Substance Abuse Rehabilitation Facility
- Enoch, UT
National Provider Identifier
1396986162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- Practice address
- 4747 N Oregon TRL
Enoch, UT 84721-7443 - Phone
- (435) 586-2592
- NPI assigned
- Mar 9, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | Primary |
Addresses
Primary practice location
4747 N Oregon TRL
Enoch, UT 84721-7443
Mailing address
4747 N Oregon TRL
Enoch, UT 84721-7443
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": "1236556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236556800000",
"number": "1396986162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4747 N OREGON TRL",
"city": "ENOCH",
"state": "UT",
"postal_code": "847217443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4747 N OREGON TRL",
"city": "ENOCH",
"state": "UT",
"postal_code": "847217443",
"telephone_number": "435-586-2592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBINSON",
"first_name": "JESSE",
"middle_name": "GRAYDON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-09",
"last_updated": "2009-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Enoch, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.