Active NPI
Caitlin Jensen
- Physician Assistant
- Draper, UT
National Provider Identifier
1588133185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 11027061-1206
- Practice address
- 14425 S Bitterbrush LN
Draper, UT 84020-9501 - Phone
- (801) 576-7000
- NPI assigned
- Nov 13, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 11027061-1206 | UT | Primary |
Addresses
Primary practice location
14425 S Bitterbrush LN
Draper, UT 84020-9501
Mailing address
489 Wilderness Dr
Alpine, UT 84004-1402
Phone (801) 750-3028
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11027061-1206 | UT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542067200000",
"number": "1588133185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "489 WILDERNESS DR",
"city": "ALPINE",
"state": "UT",
"postal_code": "840041402",
"telephone_number": "801-750-3028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14425 S BITTERBRUSH LN",
"city": "DRAPER",
"state": "UT",
"postal_code": "840209501",
"telephone_number": "801-576-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "CAITLIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-13",
"last_updated": "2018-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "11027061-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.