Individual provider Active NPI

Rulon Mark Hinckley, PHD, LMFT

  • Clinical Social Worker
  • South Jordan, UT
National Provider Identifier
1679638191
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1168163501 Issued in UT
Practice address
11175 S Redwood Rd
South Jordan, UT 84095-8208
Phone
(801) 484-9911
Fax
(801) 302-7954
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1168163501 UT Primary

Addresses

Primary practice location

11175 S Redwood Rd
South Jordan, UT 84095-8208

Mailing address

11175 S Redwood Rd
South Jordan, UT 84095-8208
Phone (801) 484-9911

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1168163501UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679638191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11175 S REDWOOD RD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958208",
            "telephone_number": "801-484-9911",
            "fax_number": "801-302-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11175 S REDWOOD RD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958208",
            "telephone_number": "801-484-9911",
            "fax_number": "801-302-7954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINCKLEY",
        "first_name": "RULON",
        "middle_name": "MARK",
        "credential": "PHD, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "1168163501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.