Individual provider Active NPI

Yanabah Tachene Wood

  • Social Worker
  • Salt Lake City, UT
National Provider Identifier
1497328090
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
5075915-3502 Issued in UT
Practice address
660 S 200 E Ste 250
Salt Lake City, UT 84111-3846
Phone
(801) 359-2256
NPI assigned
Jul 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 5075915-3502 UT Primary

Addresses

Primary practice location

660 S 200 E Ste 250
Salt Lake City, UT 84111-3846

Mailing address

699 S 45 E
Vineyard, UT 84059-5549
Phone (801) 602-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230411002847 TX Practitioner - Clinical Social Worker 0244605947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Confederated Tribes of the Goshute ReservationGroup PAC ID 0042451650, 58 clinicians

Practice addresses (Care Compare)

660 S 200 E
250 Sacred Cir Hlthcare
Salt Lake City, UT 84111-3846
Phone (801) 395-2256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5075915-3502UTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Confederated Tribes of the Goshute Reservation CurrentSince Mar 1, 2023 Accepting new patients
Confederated Tribes of the Goshute Reservation CurrentSince Mar 1, 2023 Accepting new patients

Locations

195 Tribal Center Rd
Ibapah, UT 84034
Phone (435) 234-1302

660 S 200 E
Slc, UT 84111
Phone (801) 355-1528

660 S 200 E
Ste 250
Slc, UT 84111
Phone (801) 395-2256

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1497328090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 S 45 E",
            "city": "VINEYARD",
            "state": "UT",
            "postal_code": "840595549",
            "telephone_number": "801-602-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "YANABAH",
        "middle_name": "TACHENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "5075915-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.