Individual provider Active NPI

Brianne Michelle Jewell, COTA/L

  • Occupational Therapy Assistant
  • South Salt Lake, UT
National Provider Identifier
1720725740
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
6267672-4202 Issued in UT
Practice address
2500 S State St
South Salt Lake, UT 84115-3164
Phone
(385) 646-5000
NPI assigned
May 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 6267672-4202 UT Primary

Addresses

Primary practice location

2500 S State St
South Salt Lake, UT 84115-3164

Mailing address

8371 S McKenzie LN
West Jordan, UT 84081-5905
Phone (801) 864-0038

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6267672-4202UTMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1720725740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8371 S MCKENZIE LN",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840815905",
            "telephone_number": "801-864-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S STATE ST",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841153164",
            "telephone_number": "385-646-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWELL",
        "first_name": "BRIANNE",
        "middle_name": "MICHELLE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "UT",
            "license": "6267672-4202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Salt Lake, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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.