Individual provider Active NPI

Jonathan Taylor, APRN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1972354876
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
13811203-4405 Issued in UT
Practice address
1480 N 8000 W
Salt Lake City, UT 84116-3961
Phone
(801) 522-7000
NPI assigned
Mar 28, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 13811203-4405 UT Primary

Addresses

Primary practice location

1480 N 8000 W
Salt Lake City, UT 84116-3961

Mailing address

421 S Orchard Dr Unit 1324
North Salt Lake, UT 84054-1976
Phone (806) 570-0532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260501000801 TX Practitioner - Nurse Practitioner 5294203881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas Tech University Health Science Center School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12700 Park Central Dr
Suite 1050
Dallas, TX 75251-1500

5344 Alpha Rd
Dallas, TX 75240-3428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13811203-4405UTMDPsychiatric/Mental Health Nurse Practitioner

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1972354876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 S ORCHARD DR UNIT 1324",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840541976",
            "telephone_number": "806-570-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 N 8000 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841163961",
            "telephone_number": "801-522-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JONATHAN",
        "credential": "APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "13811203-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.