Individual provider Active NPI

Stephanie Plunkett, MD

  • Family Medicine Physician
  • South Jordan, UT
National Provider Identifier
1720034416
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5212615-1205 Issued in UT
Practice address
1868 W 9800 S
South Jordan, UT 84095-4713
Phone
(801) 433-2873
Fax
(801) 433-5734
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5212615-1205 UT Primary

Addresses

Primary practice location

1868 W 9800 S
South Jordan, UT 84095-4713

Mailing address

1868 W 9800 S
South Jordan, UT 84095-4713
Phone (801) 433-2873

Other identifiers 1

IdentifierTypeStateIssuer
5212615-1205OtherUTSTATE LICENSE NUMBER

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050513000211 UT Practitioner - Family Practice 2567403165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Plunkett Family Health Family Medicine CurrentSince May 3, 2021 Accepting new patients
Westview Women'S Center Family Medicine CurrentSince Jan 1, 2006 Accepting new patients
Gunnison Valley Hospital Past Accepting new patients
Jay M. Wolkov DO PC Past Accepting new patients

Locations

1868 W 9800 S
#100
South Jordan, UT 84095
Phone (801) 285-8848

3451 S 5600 W
Ste E
West Valley City, UT 84120
Phone (801) 963-1880

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1720034416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1868 W 9800 S",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954713",
            "telephone_number": "801-433-2873",
            "fax_number": "801-433-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1868 W 9800 S",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954713",
            "telephone_number": "801-433-2873",
            "fax_number": "801-433-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUNKETT",
        "first_name": "STEPHANIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "5212615-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "5212615-1205",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

Verify at the official NPI Registry.