Jake Lee Checketts

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11285620-3502

Practice address

934 S Main St
Layton, UT 84041

Phone

(801) 773-7060

NPI assigned

Jul 25, 2017

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

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Olympus Counseling Services

  • Mental Health Counselor
  • Layton, UT
  • NPI 1972202471
  Medicare reassignment NPD

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1689197394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 S MAIN ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 S MAIN ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "84041",
            "telephone_number": "801-773-7060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4460 S. Highland Dr. #230",
            "address_purpose": "LOCATION",
            "city": "Murry",
            "state": "UT",
            "postal_code": "84124",
            "country_code": "US",
            "telephone_number": "888-949-4864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHECKETTS",
        "first_name": "JAKE",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-25",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "11285620-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcus Chavez
• McKella Chavez
• Timothy Lee Chavez
• Sakura Chea
• Darin D. Checketts, D.O.
• Scott R Checketts, MD
• Ronald Cheese-Martinez
• Priscilla Aye Chen, MD
• Alexandra Cheney
• Chelsie Cheney

• Clinical Social Worker in Layton, UT
• Providers in Layton, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.