Active NPI
Jacob Kean, PH.D.
- Speech-Language Pathologist
- Salt Lake City, UT
National Provider Identifier
1760851075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22003878A
- Practice address
- 295 Chipeta Way
Williams Building, RM 1N490
Salt Lake City, UT 84108 - Phone
- (801) 213-3751
- NPI assigned
- Sep 16, 2015
- Last updated
- Sep 16, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 22003878A | IN | Primary |
Addresses
Primary practice location
295 Chipeta Way
Williams Building, RM 1N490
Salt Lake City, UT 84108
Mailing address
295 Chipeta Way
Williams Building, RM 1N490
Salt Lake City, UT 84108
Phone (801) 213-3751
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22003878A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442361600000",
"number": "1760851075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "295 CHIPETA WAY",
"address_2": "WILLIAMS BUILDING, RM 1N490",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84108",
"telephone_number": "801-213-3751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 CHIPETA WAY",
"address_2": "WILLIAMS BUILDING, RM 1N490",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84108",
"telephone_number": "801-213-3751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEAN",
"first_name": "JACOB",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-16",
"last_updated": "2015-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22003878A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.