Individual provider Active NPI

Ryan Sperry Nelson, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1720307267
Registry record updated May 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6625079-3501 Issued in UT
Practice address
344 E 100 S
Suite 301
Salt Lake City, UT 84111-1700
Phone
(801) 322-4257
NPI assigned
May 24, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6625079-3501 UT Primary

Addresses

Primary practice location

344 E 100 S
Suite 301
Salt Lake City, UT 84111-1700

Mailing address

344 E 100 S
Suite 301
Salt Lake City, UT 84111-1700
Phone (801) 322-4257

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160811002629 UT Practitioner - Clinical Social Worker 2668766734 Practice locations: Riverton, UT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13531 S Lovers LN
Riverton, UT 84065-5667
Phone (801) 706-1818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1720307267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 E 100 S",
            "address_2": "SUITE 301",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841111700",
            "telephone_number": "801-322-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 E 100 S",
            "address_2": "SUITE 301",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841111700",
            "telephone_number": "801-322-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "RYAN",
        "middle_name": "SPERRY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-24",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6625079-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.