Active NPI
Jared Moetao Tongaonevai, RN
- Psychiatric/Mental Health Registered Nurse
- SLC, UT
National Provider Identifier
1497725022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Registered Nurse
- License
- 5185700-3102
- Practice address
- 1020 S Main St
SLC, UT 84101-3176 - Phone
- (801) 539-7028
- NPI assigned
- Jan 25, 2006
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 5185700-3102 | UT | Primary |
Addresses
Primary practice location
1020 S Main St
SLC, UT 84101-3176
Mailing address
2085 E 9100 S
Sandy, UT 84093-2525
Phone (801) 792-5358
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107031025101 | Other | UT | INTERMTN HEALTH CARE |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5185700-3102 | UT | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207785600000",
"number": "1497725022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2085 E 9100 S",
"city": "SANDY",
"state": "UT",
"postal_code": "840932525",
"telephone_number": "801-792-5358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 S MAIN ST",
"city": "SLC",
"state": "UT",
"postal_code": "841013176",
"telephone_number": "801-539-7028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TONGAONEVAI",
"first_name": "JARED",
"middle_name": "MOETAO",
"name_prefix": "Mr.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2008-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "UT",
"license": "5185700-3102",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERMTN HEALTH CARE",
"identifier": "107031025101",
"state": "UT"
}
],
"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 Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.