Individual provider Active NPI

Jamie J Clinton-Lont, NURSE PRACTITIONER

  • Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1689695504
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
264094-4405 Issued in UT
Practice address
4385 Adonis Dr
Salt Lake City, UT 84124-3434
Phone
(801) 424-1323
NPI assigned
Jul 23, 2006
Sex
Female
Sole proprietor
Yes

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
Nurse Practitioner 363L00000X 264094-4405 UT Primary

Addresses

Primary practice location

4385 Adonis Dr
Salt Lake City, UT 84124-3434

Mailing address

4385 Adonis Dr
Salt Lake City, UT 84124-3434
Phone (801) 424-1323

Other identifiers 1

IdentifierTypeStateIssuer
264094-4405OtherUTLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
264094-4405UTMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689695504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4385 ADONIS DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841243434",
            "telephone_number": "801-424-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4385 ADONIS DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841243434",
            "telephone_number": "801-424-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINTON-LONT",
        "first_name": "JAMIE",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "264094-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "264094-4405",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.