Individual provider Active NPI

Jon T. Poore', B.S.R.N.

  • Registered Nurse
  • Salt Lake City, UT
National Provider Identifier
1538147277
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
3306403102 Issued in UT
Practice address
500 South
530 East
Salt Lake City, UT 84102
Phone
(801) 538-2057
Fax
(801) 596-2515
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 3306403102 UT Primary

Addresses

Primary practice location

500 South
530 East
Salt Lake City, UT 84102

Mailing address

350 S 200 W
#C507
Salt Lake City, UT 84101-1828
Phone (801) 580-7624

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

State licenses

LicenseStateTypeSpecialty
3306403102UTMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1538147277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S 200 W",
            "address_2": "#C507",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841011828",
            "telephone_number": "801-580-7624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SOUTH",
            "address_2": "530 EAST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84102",
            "telephone_number": "801-538-2057",
            "fax_number": "801-596-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POORE'",
        "first_name": "JON",
        "middle_name": "T.",
        "name_prefix": "Mr.",
        "credential": "B.S.R.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "3306403102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.