Individual provider Active NPI

Terry J Bateman, CSW

  • Clinical Social Worker
  • Taylorsville, UT
National Provider Identifier
1629780465
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
71409079-3502 Issued in UT
Practice address
5689 S Redwood Rd Unit 275689
Taylorsville, UT 84123-5447
Phone
(801) 644-8514
NPI assigned
Dec 22, 2022
Last updated
Dec 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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 71409079-3502 UT Primary

Addresses

Primary practice location

5689 S Redwood Rd Unit 275689
Taylorsville, UT 84123-5447

Mailing address

9861 S Evening Moon Way
Sandy, UT 84070-3225
Phone (801) 644-8514

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Laptop Health Information Exchange (HIE)

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
I20240923002736 UT Practitioner - Clinical Social Worker 5991246563 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71409079-3502UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Karen W. Malm, PH.D., P.C. CurrentSince Aug 1, 2024 Accepting new patients

Locations

5689 S Redwood Rd
Ste 27
Taylorsville, UT 84123
Phone (801) 266-2485

5689 S Redwood Rd
Unit 27
Taylorsville, UT 84123
Phone (801) 266-2485

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1629780465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9861 S EVENING MOON WAY",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840703225",
            "telephone_number": "801-644-8514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5689 S REDWOOD RD UNIT 275689",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841235447",
            "telephone_number": "801-644-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATEMAN",
        "first_name": "TERRY",
        "middle_name": "J",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "71409079-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "endpointDescription": "Laptop",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5689 S Redwood Rd Unit 275689",
            "city": "Taylorsville",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841235447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Taylorsville, UT

Sources for this page

Verify at the official NPI Registry.