Individual provider Active NPI

Shannon Jewkes, CSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1922888106
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13050277-3502 Issued in UT
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

Updated by the provider on Oct 4, 2023

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 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

LicenseStateTypeSpecialty
13050277-3502UTMDClinical 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.

Verify at the official NPI Registry.