NPIMap

Individual provider Active NPI

Jennifer Jenkinson, FNP-C

  • Family Nurse Practitioner
  • Sandy, UT
National Provider Identifier
1891125100
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
223447-4405 Issued in UT
Practice address
1403 E Sego Lily Dr
Sandy, UT 84092-4350
Phone
(801) 316-9620
NPI assigned
Nov 22, 2013
Last updated
Jun 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 223447-4405 UT Primary

Addresses

Primary practice location

1403 E Sego Lily Dr
Sandy, UT 84092-4350

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (801) 316-9620

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address medreview@reverehealth.com Central Utah Clinic, P.C.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140312001244 UT Practitioner - Nurse Practitioner 6204066756 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

395 W Bulldog Blvd
Suite 504
Provo, UT 84604-3323
Phone (801) 357-7291

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince May 15, 2023 Accepting new patients
Optum Medical Group P a Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
Jordan Ridge Family Medicine LLC Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
Jordan Ridge Family Medicine LLC Family Medicine CurrentSince Feb 1, 2021 Accepting new patients
Ihc Health Services Inc CurrentSince May 15, 2023 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Jordan Ridge Family Medicine LLC CurrentSince Feb 1, 2021 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

395 W Cougar Blvd
Ste 504
Provo, UT 84604
Phone (801) 357-7291

1403 E Sego Lily Dr
Sandy, UT 84092
Phone (801) 265-2212

6321 S Redwood Rd
Ste 201
Taylorsville, UT 84123
Phone (801) 265-2212

4071 S 4000 W
West Valley City, UT 84120
Phone (801) 265-0103

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1891125100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "801-316-9620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 E SEGO LILY DR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840924350",
            "telephone_number": "801-316-9620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINSON",
        "first_name": "JENNIFER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-22",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "223447-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Central Utah Clinic, P.C.",
            "address_1": "3300 Running Creek Way",
            "city": "Lehi",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840435563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

Verify at the official NPI Registry.