Jeanie Colbert O'Donnell, NURSE PRACTITIONER

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

190548-4405 Issued in UT

Practice address

500 Foothill Blvd
Salt Lake City, UT 84148-0001

Phone

(801) 582-1565

Fax

(801) 584-1298

NPI assigned

Jun 20, 2006

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1720024714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2553 VILLAGE CIR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841082439",
            "telephone_number": "801-583-0842",
            "fax_number": "801-584-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FOOTHILL BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841480001",
            "telephone_number": "801-582-1565",
            "fax_number": "801-584-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "JEANIE",
        "middle_name": "COLBERT",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "UT",
            "license": "190548-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin O'Connor
• Lillian O'Connor, MS CF SLP
• Meghan Mary O'Connor, M.D.
• Richard Paul O'Connor
• Matthew D. O'Dell, MD
• Kirk N O'Donnell, MD
• Michaela O'Donoghue
• Jennifer Grace O'Donohoe, M.D.
• Kathryn L. O'Gorman, MD, MS
• Christa O'Hara

• Gerontology Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Gerontology Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.