Individual provider Active NPI

Madeleine Susanna Homer

  • School Social Worker
  • Sandy, UT
National Provider Identifier
1659984847
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
Practice address
9361 S 300 E
Sandy, UT 84070-2902
Phone
(801) 826-5000
NPI assigned
Aug 26, 2020
Last updated
May 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
School Social Worker 1041S0200X Primary

Addresses

Primary practice location

9361 S 300 E
Sandy, UT 84070-2902

Mailing address

7750 S 300 E
Midvale, UT 84047-2725
Phone (801) 696-7436

Other practice location 1

1760 W 4805 S
Taylorsville, UT 84129-1177
Phone (801) 955-9110 ext. 108

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

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1659984847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7750 S 300 E",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472725",
            "telephone_number": "801-696-7436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9361 S 300 E",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702902",
            "telephone_number": "801-826-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1760 W 4805 S",
            "address_purpose": "LOCATION",
            "city": "Taylorsville",
            "state": "UT",
            "postal_code": "841291177",
            "country_code": "US",
            "telephone_number": "801-955-9110 x108",
            "fax_number": "801-955-9411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOMER",
        "first_name": "MADELEINE",
        "middle_name": "SUSANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-26",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.