Active NPI
Cody Johnson
- Clinical Social Worker
- Provo, UT
National Provider Identifier
1881904613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 9082143-3501
- Practice address
- Trailtalk
3585 N University Ave. Ste 250
Provo, UT 84604 - Phone
- (435) 513-2715
- NPI assigned
- Oct 14, 2010
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 9082143-3501 | UT | Primary |
Addresses
Primary practice location
Trailtalk
3585 N University Ave. Ste 250
Provo, UT 84604
Mailing address
263 Ashbrook Circle
Midvale, UT 84047
Phone (801) 834-1606
Other practice location 1
13073 Wheatfield Way
Draper, UT 84020-9253
Phone (800) 495-0946
Other practice location 2
11457 S 700 W
Draper, UT 84020-9426
Phone (866) 678-2425
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 |
|---|---|---|---|
| 9082143-3501 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555459200000",
"number": "1881904613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "263 ASHBROOK CIRCLE",
"city": "MIDVALE",
"state": "UT",
"postal_code": "84047",
"telephone_number": "801-834-1606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "TRAILTALK",
"address_2": "3585 N UNIVERSITY AVE. STE 250",
"city": "PROVO",
"state": "UT",
"postal_code": "84604",
"telephone_number": "435-513-2715"
}
],
"practiceLocations": [
{
"address_1": "13073 Wheatfield Way",
"address_purpose": "LOCATION",
"city": "Draper",
"state": "UT",
"postal_code": "840209253",
"country_code": "US",
"telephone_number": "800-495-0946",
"fax_number": "801-495-2076",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11457 S 700 W",
"address_purpose": "LOCATION",
"city": "Draper",
"state": "UT",
"postal_code": "840209426",
"country_code": "US",
"telephone_number": "866-678-2425",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "CODY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-10-14",
"last_updated": "2019-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "9082143-3501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.