NPIMap

Organization Active NPI

CNS Professional Services

Doing business as CNS Professional Care

  • Primary Care Nurse Practitioner
  • West Valley City, UT
National Provider Identifier
1508248964
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
CNS PROFESSIONAL SERVICES
Doing business as
CNS Professional Care
Practice address
2830 S Redwood Rd
West Valley City, UT 84119-5625
Phone
(801) 233-6100
Fax
(801) 233-6110
NPI assigned
Jun 22, 2015
Last updated
Mar 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Authorized official

Name
Joel Macey
Title
President and Ceo
Phone
(801) 233-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X Primary

Addresses

Primary practice location

2830 S Redwood Rd
West Valley City, UT 84119-5625

Mailing address

2830 S Redwood Rd
West Valley City, UT 84119-5625
Phone (801) 233-6100

Other names 1

  • CNS Professional Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160115001719 UT Part B Supplier - Clinic/Group Practice 4486826294 Receives reassigned benefits from 3 practitioners
Practice locations: West Valley City, UT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2238578CNS Professional Services2830 S Redwood Road, West Valley City, UT 84119Certificate of waiverOct 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
CNS Medical Equipment S4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

2830 S Redwood Rd
West Valley City, UT 84119
Phone (801) 233-6100

2830 S Redwood Rd
Ste C
West Valley City, UT 84119
Phone (801) 639-5454

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741219200000",
    "number": "1508248964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 S REDWOOD RD",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841195625",
            "telephone_number": "801-233-6100",
            "fax_number": "801-233-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 S REDWOOD RD",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841195625",
            "telephone_number": "801-233-6100",
            "fax_number": "801-233-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CNS PROFESSIONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-22",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A",
        "authorized_official_last_name": "MACEY",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "801-233-6100"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CNS Professional Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Valley City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.