Individual provider Active NPI

Jennifer Lynne Mijangos, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1558892968
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
56620053501 Issued in UT
Practice address
1950 Circle of Hope
Huntsman Cancer Institute
Salt Lake City, UT 84112-9460
Phone
(801) 587-4761
Fax
(801) 585-3046
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 56620053501 UT Primary

Addresses

Primary practice location

1950 Circle of Hope
Huntsman Cancer Institute
Salt Lake City, UT 84112-9460

Mailing address

1950 Circle of Hope
Huntsman Cancer Institute
Salt Lake City, UT 84112
Phone (801) 587-4761

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JMIJANGOS47501@DIRECT.MED.UTAH.EDU Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20180822001634 UT Practitioner - Clinical Social Worker 4688923725 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56620053501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah CurrentSince Jun 20, 2018 Accepting new patients
University of Utah CurrentSince Jun 20, 2018 Accepting new patients

Locations

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100

Interoperability endpoints

  • Direct secure messaging: jmijangos47501@direct.med.utah.edu

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1558892968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 CIRCLE OF HOPE",
            "address_2": "HUNTSMAN CANCER INSTITUTE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84112",
            "telephone_number": "801-587-4761",
            "fax_number": "801-585-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 CIRCLE OF HOPE",
            "address_2": "HUNTSMAN CANCER INSTITUTE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841129460",
            "telephone_number": "801-587-4761",
            "fax_number": "801-585-3046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIJANGOS",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "56620053501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JMIJANGOS47501@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.