Individual provider Active NPI

Hillary Jane Poor, CSW

  • Social Worker
  • Park City, UT
National Provider Identifier
1578733150
Registry record updated Aug 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
67527093502 Issued in UT
Practice address
1753 Sidewinder Dr
Park City, UT 84060-7258
Phone
(435) 649-8347
NPI assigned
Mar 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 67527093502 UT Primary

Addresses

Primary practice location

1753 Sidewinder Dr
Park City, UT 84060-7258

Mailing address

1753 Sidewinder Dr
Park City, UT 84060-7258
Phone (435) 649-8347

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
67527093502UTMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249257600000",
    "number": "1578733150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1753 SIDEWINDER DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607258",
            "telephone_number": "435-649-8347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 SIDEWINDER DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607258",
            "telephone_number": "435-649-8347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOR",
        "first_name": "HILLARY",
        "middle_name": "JANE",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-10",
        "last_updated": "2009-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "67527093502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2009; 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.