Active NPI
Shannon Jewkes, CSW
- Clinical Social Worker
- Salt Lake City, UT
National Provider Identifier
1922888106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 13050277-3502
- Practice address
- 1600 W 2200 S
Salt Lake City, UT 84119-1495 - Phone
- (801) 886-8900
- NPI assigned
- Oct 4, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 13050277-3502 | UT | Primary |
Addresses
Primary practice location
1600 W 2200 S
Salt Lake City, UT 84119-1495
Mailing address
5277 N Wild Pear Dr
Eagle Mountain, UT 84005-6375
Phone (801) 755-4839
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 |
|---|---|---|---|
| 13050277-3502 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696377600000",
"number": "1922888106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5277 N WILD PEAR DR",
"city": "EAGLE MOUNTAIN",
"state": "UT",
"postal_code": "840056375",
"telephone_number": "801-755-4839",
"fax_number": "801-755-4839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 W 2200 S",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841191495",
"telephone_number": "801-886-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEWKES",
"first_name": "SHANNON",
"name_prefix": "Mrs.",
"credential": "CSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-04",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "13050277-3502",
"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 Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.