Active NPI
Nicole Crockett, RPH
- Pharmacist
- South Jordan, UT
National Provider Identifier
1932700747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 341246-1701
- Practice address
- 3590 W South Jordan Pkwy
South Jordan, UT 84095-8916 - Phone
- (801) 601-3119
- Fax
- (801) 601-3124
- NPI assigned
- Nov 6, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 341246-1701 | UT | Primary |
Addresses
Primary practice location
3590 W South Jordan Pkwy
South Jordan, UT 84095-8916
Mailing address
3866 W Salinas Dr
Riverton, UT 84065-7640
Phone (801) 450-8238
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 341246-1701 | UT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604620800000",
"number": "1932700747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3866 W SALINAS DR",
"city": "RIVERTON",
"state": "UT",
"postal_code": "840657640",
"telephone_number": "801-450-8238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3590 W SOUTH JORDAN PKWY",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840958916",
"telephone_number": "801-601-3119",
"fax_number": "801-601-3124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROCKETT",
"first_name": "NICOLE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-06",
"last_updated": "2020-11-06",
"certification_date": "2020-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "341246-1701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.