NPIMap

Organization Active NPI

Intermountain Senior Clinic

  • Clinical Social Worker
  • Murray, UT
National Provider Identifier
1982958641
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6262134-3501 Issued in UT
Legal business name
INTERMOUNTAIN SENIOR CLINIC
Practice address
5770 S 250E Suite 210
Murray, UT 84107
Phone
(801) 314-4544
Fax
(801) 314-4565
NPI assigned
Nov 2, 2012
Organization subpart
Yes
Parent organization
INTERMOUNTAIN HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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

Authorized official

Name
Kay Sue Simons, MSW, LCSW
Title
Licensed Clinical Social Worker
Phone
(801) 314-4550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6262134-3501 UT Primary

Addresses

Primary practice location

5770 S 250E Suite 210
Murray, UT 84107

Mailing address

5770 S 250E Suite 210
Murray, UT 84107
Phone (801) 314-4544

National Provider Directory

National Provider Directory
Tax ID family
Bradley S Thompson DO479 organizations share this tax ID, including this one
Part of
Bradley S Thompson DO

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Locations

5770 S 250 E
Ste 210
Salt Lake City, UT 84107
Phone (801) 314-4544

NPI Registry JSON

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

{
    "created_epoch": "1351814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351814400000",
    "number": "1982958641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5770 S 250E SUITE 210",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "84107",
            "telephone_number": "801-314-4544",
            "fax_number": "801-314-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 S 250E SUITE 210",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "84107",
            "telephone_number": "801-314-4544",
            "fax_number": "801-314-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN SENIOR CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERMOUNTAIN HEALTHCARE",
        "enumeration_date": "2012-11-02",
        "last_updated": "2012-11-02",
        "status": "A",
        "authorized_official_last_name": "SIMONS",
        "authorized_official_first_name": "KAY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "801-314-4550",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6262134-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.