Individual provider Active NPI

Jonathan E Crane, LCSW

  • Clinical Social Worker
  • Vernal, UT
National Provider Identifier
1669775854
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7717942-3502 Issued in UT
Practice address
1140 W 500 S Ste 9
Vernal, UT 84078-2912
Phone
(435) 789-6300
Fax
(435) 725-6325
NPI assigned
Dec 10, 2010
Last updated
Feb 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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 7717942-3502 UT Primary

Addresses

Primary practice location

1140 W 500 S Ste 9
Vernal, UT 84078-2912

Mailing address

1140 W 500 S Ste 9
Vernal, UT 84078-2912
Phone (435) 789-6300

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
I20140122000737 UT Practitioner - Clinical Social Worker 8022246941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1140 W 500
Suite 9
Vernal, UT 84078-2912

285 W 800
Roosevelt, UT 84066-3707
Phone (435) 725-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7717942-3502UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Uintah Basin Tri-County Mental Health and Substance Abuse Local Author CurrentSince Dec 14, 2013 Accepting new patients

Locations

285 W 800 S
Roosevelt, UT 84066
Phone 43572563006340

1140 W 500 S
Ste 9
Vernal, UT 84078

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": "1291939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1669775854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 W 500 S STE 9",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840782912",
            "telephone_number": "435-789-6300",
            "fax_number": "357-256-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W 500 S STE 9",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840782912",
            "telephone_number": "435-789-6300",
            "fax_number": "435-725-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANE",
        "first_name": "JONATHAN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-10",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "7717942-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernal, UT

Sources for this page

Verify at the official NPI Registry.