Individual provider Active NPI

Kristina Simons, LCSW

  • Clinical Social Worker
  • Tooele, UT
National Provider Identifier
1982683777
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
310140-3501 Issued in UT
Practice address
100 S 1000 W
Tooele, UT 84074-4010
Phone
(888) 949-4864
NPI assigned
Jan 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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 310140-3501 UT Primary

Addresses

Primary practice location

100 S 1000 W
Tooele, UT 84074-4010

Mailing address

PO Box 572070
Murray, UT 84157-2070
Phone (801) 263-7138

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190322002087 UT Practitioner - Clinical Social Worker 2163762436 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

3336 S 4155
West Valley City, UT 84120

82 S 1100
Suite 103
Salt Lake City, UT 84102-1889
Phone (801) 505-5370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
310140-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince May 1, 2023 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince May 1, 2023 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Physician Group of Utah Inc CurrentSince May 31, 2022 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

82 S 1100 E
Ste 103
Salt Lake Cty, UT 84102
Phone (801) 505-5370

2530 W 4700 S
Ste B8
Taylorsville, UT 84129
Phone (801) 967-5866

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Organizations & group practices 5

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1982683777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 572070",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841572070",
            "telephone_number": "801-263-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S 1000 W",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840744010",
            "telephone_number": "888-949-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "KRISTINA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "310140-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tooele, UT

Sources for this page

Verify at the official NPI Registry.