Individual provider Active NPI

Katelyn Peterson

  • Social Worker
  • West Valley City, UT
National Provider Identifier
1902285422
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
8658247-3502 Issued in UT
Practice address
4391 S Falcon St
West Valley City, UT 84120-5353
Phone
(801) 831-1403
NPI assigned
May 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 8658247-3502 UT Primary

Addresses

Primary practice location

4391 S Falcon St
West Valley City, UT 84120-5353

Mailing address

4391 S Falcon St
West Valley City, UT 84120-5353

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

LicenseStateTypeSpecialty
8658247-3502UTMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1432857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1902285422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4391 S FALCON ST",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841205353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4391 S FALCON ST",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841205353",
            "telephone_number": "801-831-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-29",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "8658247-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.

Verify at the official NPI Registry.