Organization Active NPI

JC Aljammal PLLC

  • Clinic/Center
  • Salt Lake City, UT
National Provider Identifier
1710466115
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
JC ALJAMMAL PLLC
Practice address
4465 S 900 E Ste 200
Salt Lake City, UT 84124-2695
Phone
(412) 996-0131
Fax
(801) 683-6845
NPI assigned
Aug 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Laura John
Title
Credentialing Coordinator
Phone
(801) 231-6986

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

4465 S 900 E Ste 200
Salt Lake City, UT 84124-2695

Mailing address

PO Box 520247
Salt Lake City, UT 84152-0247
Phone (412) 996-0131

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1710466115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520247",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841520247",
            "telephone_number": "412-996-0131",
            "fax_number": "801-683-6845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 S 900 E STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242695",
            "telephone_number": "412-996-0131",
            "fax_number": "801-683-6845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JC ALJAMMAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-07",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "801-231-6986"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.