Derick Jensen

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

68 S 600 E
SLC, UT 84102-1007

Phone

(801) 322-1001

Fax

(801) 359-3864

NPI assigned

Jan 30, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1659794402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 W 13680 S",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840961710",
            "telephone_number": "801-322-1001",
            "fax_number": "801-359-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 S 600 E",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841021007",
            "telephone_number": "801-322-1001",
            "fax_number": "801-359-3864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "DERICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-30",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alina Jameson, MS, RDN, CSSD
• Trevor Jameson, M.S., A.T.C.
• Leah E Jaramillo, CMFTI
• Adam Jarvis, PT, DPT
• Alisha Jensen
• Joelle Jensen, RBT
• Sandralee Jensen
• Kasey Ann Jenson
• Rhoda L Jenson, AUD
• Savannah Jewkes

• Community Health Worker in SLC, UT
• Providers in SLC, UT by specialty
• Community Health Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.