Individual provider Active NPI

Chris Roach

  • Clinical Social Worker
  • Taylorsville, UT
National Provider Identifier
1780106641
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5709252-3501 Issued in UT
Practice address
5677 S Redwood Rd Unit 18
Taylorsville, UT 84123-5454
Phone
(435) 526-5996
NPI assigned
Jul 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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 5709252-3501 UT Primary

Addresses

Primary practice location

5677 S Redwood Rd Unit 18
Taylorsville, UT 84123-5454

Mailing address

5677 S Redwood Rd Unit 18
Taylorsville, UT 84123-5454

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
I20250123001565 UT Practitioner - Clinical Social Worker 1951830744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Beacon Therapy of UtahGroup PAC ID 3577917178, 6 clinicians

Practice addresses (Care Compare)

5677 S Redwood Rd
Unit 18
Taylorsville, UT 84123-5454
Phone (801) 742-1011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Therapy of Utah Clinical CurrentSince Jan 17, 2025 Accepting new patients
James Mason Centers for Recovery Past Accepting new patients

Locations

5677 S Redwood Rd
Unit 18
Taylorsville, UT 84123
Phone (385) 526-5996

Organizations & group practices 2

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1780106641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5677 S REDWOOD RD UNIT 18",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841235454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5677 S REDWOOD RD UNIT 18",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841235454",
            "telephone_number": "435-526-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "CHRIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-12",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "5709252-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorsville, UT

Sources for this page

Verify at the official NPI Registry.