NPIMap

Organization Active NPI

Petersen Farms Assisted Living & Memory Care

  • Assisted Living Facility
  • South Weber, UT
National Provider Identifier
1518525989
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
PETERSEN FARMS ASSISTED LIVING & MEMORY CARE
Practice address
6980 S. 475 E.
South Weber, UT 84405
Phone
(801) 479-6000
NPI assigned
May 31, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2019

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

Authorized official

Name
Brent Croxford
Title
Administrator
Phone
(801) 388-3848

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

6980 S. 475 E.
South Weber, UT 84405

Mailing address

6980 S. 475 E.
South Weber, UT 84405
Phone (801) 479-6000

National Provider Directory

National Provider Directory

Locations

6980 S 475 E
South Weber, UT 84405
Phone (801) 479-6000

NPI Registry JSON

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559260800000",
    "number": "1518525989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6980 S. 475 E.",
            "city": "SOUTH WEBER",
            "state": "UT",
            "postal_code": "84405",
            "telephone_number": "801-479-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6980 S. 475 E.",
            "city": "SOUTH WEBER",
            "state": "UT",
            "postal_code": "84405",
            "telephone_number": "801-479-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSEN FARMS ASSISTED LIVING & MEMORY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-05-31",
        "status": "A",
        "authorized_official_last_name": "CROXFORD",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "801-388-3848"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Weber, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; 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.