Active NPI
Kenton Jepsen, CSW-I
- Social Worker
- Draper, UT
National Provider Identifier
1720826068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 12324757-3502
- Practice address
- 248 E 13800 S Ste 4
Draper, UT 84020-5011 - Phone
- (801) 816-1801
- NPI assigned
- Jul 19, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 12324757-3502 | UT | Primary |
Addresses
Primary practice location
248 E 13800 S Ste 4
Draper, UT 84020-5011
Mailing address
463 Millcreek Rd
Pleasant Grove, UT 84062-8814
Phone (760) 207-4752
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12324757-3502 | UT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721347200000",
"number": "1720826068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "463 MILLCREEK RD",
"city": "PLEASANT GROVE",
"state": "UT",
"postal_code": "840628814",
"telephone_number": "760-207-4752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "248 E 13800 S STE 4",
"city": "DRAPER",
"state": "UT",
"postal_code": "840205011",
"telephone_number": "801-816-1801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEPSEN",
"first_name": "KENTON",
"credential": "CSW-I",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-19",
"last_updated": "2024-07-19",
"certification_date": "2024-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "12324757-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.