Active NPI
Johnathan Davis
- Community Health Worker
- Salt Lake City, UT
National Provider Identifier
1962023309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 252 W Brooklyn Ave
Salt Lake City, UT 84101-3024 - Phone
- (801) 363-9400
- NPI assigned
- Apr 27, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Salt Lake City, UT
- NPI 1548367881
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Volunteers of America of Utah Inc | Past | Accepting new patients |
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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
252 W Brooklyn Ave
Salt Lake City, UT 84101-3024
Mailing address
252 W Brooklyn Ave
Salt Lake City, UT 84101-3024
Phone (801) 363-9400
NPI Registry JSON
{
"created_epoch": "1587945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587945600000",
"number": "1962023309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "252 W BROOKLYN AVE",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841013024",
"telephone_number": "801-363-9400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "252 W BROOKLYN AVE",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841013024",
"telephone_number": "801-363-9400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JOHNATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-27",
"last_updated": "2020-04-27",
"certification_date": "2020-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"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 Apr 27, 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.