Active NPI
Baylee Lyn Jackson
- Social Worker
- Evanston, WY
National Provider Identifier
1972247179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 849 Front St Ste 103
Evanston, WY 82930-3475 - Phone
- (307) 444-5760
- NPI assigned
- Apr 24, 2022
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
849 Front St Ste 103
Evanston, WY 82930-3475
Mailing address
PO Box 1003
Mountain View, WY 82939-1003
Phone (307) 747-7586
Other practice location 1
90 E 200 N
Logan, UT 84321-4034
Phone (435) 752-0750
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1972247179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1003",
"city": "MOUNTAIN VIEW",
"state": "WY",
"postal_code": "829391003",
"telephone_number": "307-747-7586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "849 FRONT ST STE 103",
"city": "EVANSTON",
"state": "WY",
"postal_code": "829303475",
"telephone_number": "307-444-5760"
}
],
"practiceLocations": [
{
"address_1": "90 E 200 N",
"address_purpose": "LOCATION",
"city": "Logan",
"state": "UT",
"postal_code": "843214034",
"country_code": "US",
"telephone_number": "435-752-0750",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "BAYLEE",
"middle_name": "LYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-24",
"last_updated": "2024-06-18",
"certification_date": "2024-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.