Active NPI
Bruce W Jasper, PH.D.
- Clinical Neuropsychologist
- Murray, UT
National Provider Identifier
1710177357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 11569209-2501
- Practice address
- 5171 S Cottonwood St Ste 810
Murray, UT 84107-5705 - Phone
- (801) 507-9800
- NPI assigned
- Jul 30, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 001037 | IA | |
| Clinical Neuropsychologist | 103G00000X | 11569209-2501 | UT | Primary |
Addresses
Primary practice location
5171 S Cottonwood St Ste 810
Murray, UT 84107-5705
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 507-9800
Other practice location 1
10808 S River Front Pkwy Ste 355
South Jordan, UT 84095-6300
Phone (801) 984-2881
Other practice location 2
411 10th St SE Ste 150
Cedar Rapids, IA 52403-2449
Phone (319) 369-7507
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001037 | IA | MD | Mental Health Counselor |
| 11569209-2501 | UT | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trinity Regional Medical Center | Past | Accepting new patients |
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 and National Provider Directory roles.
-
dba UnityPoint Clinic
- Emergency Medicine Physician
- Fort Dodge, IA
- NPI 1073594156
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614816000000",
"number": "1710177357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128",
"telephone_number": "801-507-9800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5171 S COTTONWOOD ST STE 810",
"city": "MURRAY",
"state": "UT",
"postal_code": "841075705",
"telephone_number": "801-507-9800"
}
],
"practiceLocations": [
{
"address_1": "10808 S River Front Pkwy Ste 355",
"address_purpose": "LOCATION",
"city": "South Jordan",
"state": "UT",
"postal_code": "840956300",
"country_code": "US",
"telephone_number": "801-984-2881",
"fax_number": "801-984-4171",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "411 10th St SE Ste 150",
"address_purpose": "LOCATION",
"city": "Cedar Rapids",
"state": "IA",
"postal_code": "524032449",
"country_code": "US",
"telephone_number": "319-369-7507",
"fax_number": "319-369-8251",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JASPER",
"first_name": "BRUCE",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-30",
"last_updated": "2021-03-04",
"certification_date": "2020-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "IA",
"license": "001037",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "UT",
"license": "11569209-2501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.