Active NPI
Jennifer Pathak
- Case Management Registered Nurse
- Salt Lake City, UT
National Provider Identifier
1639603665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Registered Nurse
- License
- 7132312-3102
- Practice address
- 447 W Bearcat Dr
Salt Lake City, UT 84115-2519 - Phone
- (801) 355-2846
- NPI assigned
- Apr 17, 2017
- 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 |
|---|---|---|---|---|
| Case Management Registered Nurse | 163WC0400X | 7132312-3102 | UT | Primary |
Addresses
Primary practice location
447 W Bearcat Dr
Salt Lake City, UT 84115-2519
Mailing address
447 W Bearcat Dr
Salt Lake City, UT 84115-2519
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 |
|---|---|---|---|
| 7132312-3102 | UT | MD | Case Management Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Volunteers of America | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Salt Lake City, UT
- NPI 1598192338
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492473600000",
"number": "1639603665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "447 W BEARCAT DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841152519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "447 W BEARCAT DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841152519",
"telephone_number": "801-355-2846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATHAK",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-17",
"last_updated": "2017-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Case Management",
"state": "UT",
"license": "7132312-3102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.