Active NPI
Alyssa Bohn
- Registered Nurse
- Tooele, UT
National Provider Identifier
1629778568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 9596249-3102
- Practice address
- 100 S 1000 W
Tooele, UT 84074-4010 - Phone
- (888) 263-7203
- NPI assigned
- Mar 8, 2023
- Last updated
- Mar 8, 2023
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 9596249-3102 | UT | Primary |
Addresses
Primary practice location
100 S 1000 W
Tooele, UT 84074-4010
Mailing address
4460 S Highland Dr Ste 120
Salt Lake City, UT 84124-3550
Phone (888) 949-4864
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 |
|---|---|---|---|
| 9596249-3102 | UT | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678233600000",
"number": "1629778568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4460 S HIGHLAND DR STE 120",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841243550",
"telephone_number": "888-949-4864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 S 1000 W",
"city": "TOOELE",
"state": "UT",
"postal_code": "840744010",
"telephone_number": "888-263-7203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHN",
"first_name": "ALYSSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-08",
"last_updated": "2023-03-08",
"certification_date": "2023-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "UT",
"license": "9596249-3102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tooele, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.