Individual provider Active NPI

Eleonora Sustaita

  • Community Health Worker
  • SLC, UT
National Provider Identifier
1497122071
Registry record updated Aug 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
344 E 100 S Ste 301
SLC, UT 84111-1727
Phone
(801) 322-4257
NPI assigned
Aug 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

344 E 100 S Ste 301
SLC, UT 84111-1727

Mailing address

2119 W 1630 N
Clinton, UT 84015-5748
Phone (385) 888-2585

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": "1440892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440892800000",
    "number": "1497122071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 W 1630 N",
            "city": "CLINTON",
            "state": "UT",
            "postal_code": "840155748",
            "telephone_number": "385-888-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 E 100 S STE 301",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841111727",
            "telephone_number": "801-322-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSTAITA",
        "first_name": "ELEONORA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-30",
        "last_updated": "2015-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in SLC, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2015; 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.