Individual provider Active NPI

Jessica Pearson, RD

  • Registered Dietitian
  • Draper, UT
National Provider Identifier
1629576236
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
6807649-4901 Issued in UT
Practice address
12247 S Cypress Point Way
Draper, UT 84020-8853
Phone
(801) 971-2523
NPI assigned
Jan 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 6807649-4901 UT Primary

Addresses

Primary practice location

12247 S Cypress Point Way
Draper, UT 84020-8853

Mailing address

12247 S Cypress Point Way
Draper, UT 84020-8853
Phone (801) 971-2523

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
6807649-4901UTMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1629576236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12247 S CYPRESS POINT WAY",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208853",
            "telephone_number": "801-971-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12247 S CYPRESS POINT WAY",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208853",
            "telephone_number": "801-971-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "JESSICA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "6807649-4901",
            "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 Jan 29, 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.

Verify at the official NPI Registry.