Individual provider Active NPI

Sue Webb, FNP

  • Nurse Practitioner
  • Sandy, UT
National Provider Identifier
1689777690
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1944174405 Issued in UT
Practice address
9829 S 1300 E Ste 101
Sandy, UT 84094-4064
Phone
(801) 572-2504
Fax
(801) 576-9800
NPI assigned
Sep 6, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 1944174405 UT Primary

Addresses

Primary practice location

9829 S 1300 E Ste 101
Sandy, UT 84094-4064

Mailing address

9829 S 1300 E Ste 101
Sandy, UT 84094-4064
Phone (801) 572-2504

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141021003233 UT Practitioner - Nurse Practitioner 7911972898 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1944174405UTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Medical Clinic PC CurrentSince Dec 27, 2023 Accepting new patients
Granger Medical Clinic PC Current Accepting new patients
Granger Medical Specialists LLC CurrentSince Nov 1, 2020 Accepting new patients
Granger Medical Specialists, LLC CurrentSince Nov 1, 2020 Accepting new patients
David B Jack MD PC PastSince Sep 2, 2004 Accepting new patients

Locations

12391 S 4000 W
Riverton, UT 84096
Phone (801) 302-1700

995 W Levoy Dr
Taylorsville, UT 84123

7181 S Campus View Dr
West Jordan, UT 84084
Phone (801) 965-3505

7181 S Campus View Dr
Ste 200
West Jordan, UT 84084
Phone (801) 965-3505

2965 W 3500 S
West Valley City, UT 84119
Phone (801) 965-3505

3725 W 4100 S
West Valley City, UT 84120
Phone (801) 965-3545

Organizations & group practices 5

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1689777690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9829 S 1300 E STE 101",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840944064",
            "telephone_number": "801-572-2504",
            "fax_number": "801-576-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9829 S 1300 E STE 101",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840944064",
            "telephone_number": "801-572-2504",
            "fax_number": "801-576-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "SUE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "1944174405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

Verify at the official NPI Registry.