JENNIFER SMITH SHAW (NPI# 1104253954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104253954 |
Entity Type | Individual |
Full Name | JENNIFER SMITH SHAW |
Credential | APRN |
Practice Address |
1950 Circle of Hope Salt Lake City UT 84112-5550 |
Mailing Address |
127 S 500 E Ste 600 Salt Lake City UT 84102-1971 |
Practice Telephone | 8015850100 |
Practice Fax Number | 8015817575 |
Mailing Telephone | 8015876705 |
Mailing Fax Number | 8017158228 |
Enumeration Date | 2013-10-10 |
Last Update Date | 2017-10-09 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 275995-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
275995-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
275995-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
275995-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
UT | UTAH APRN LICENSE | 275995-4405 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
2000 Circle of Hope, Salt Lake City, UT 84112 | 8015850254 | 8015817575 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932761962 | Jennifer Ann Shaw | Speech-Language Pathologist | 9453 Kochville Rd, Freeland, MI 48623-8623 | 2019-06-29 |
1417324609 | Jennifer A Shaw | Psychologist | 9231 Hamer Road, Brown County Educational Service Center, Georgetown, OH 45121 | 2015-08-24 |
1891139051 | Jennifer K Shaw | Dietitian, Registered | W129n7055 Northfield Dr Bldg A, Endocrinology Clinic, Menomonee Falls, WI 53051-0538 | 2013-04-18 |
1215231303 | Jennifer Lea Shaw | Social Worker | 215 E 4th St, Waterloo, IA 50703-4701 | 2011-01-04 |
1750524336 | Jennifer M Shaw | Counselor | 736 Vt Route 15 W, Hyde Park, VT 05655-9322 | 2009-04-13 |
1700433455 | Jennifer Nichole Shaw | Case Manager/Care Coordinator | 16 E Auglaize St, Wapakoneta, OH 45895-1577 | 2019-08-19 |
1447812995 | Jennifer Joan Shaw | Psychiatry & Neurology | 988435 Nebraska Medical Ctr, Omaha, NE 68198-8435 | 2019-07-05 |
1275017519 | Jennifer Shaw | Pharmacist | 939 Sw Morrison St, Portland, OR 97205-2727 | 2018-09-22 |
1104322510 | Jennifer Shaw | Nurse Practitioner | 2103 N Rome Ave, Tampa, FL 33607-3509 | 2018-04-04 |
1780130112 | Jennifer Gail Shaw | Student in an Organized Health Care Education/Training Program | 19303 N New Tradition Rd, Sun City West, AZ 85375-3806 | 2016-08-26 |
Street Address |
1950 CIRCLE OF HOPE |
City | SALT LAKE CITY |
State | UT |
Zip Code | 84112-5550 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699724500 | Rosemary Conder | Nurse Practitioner | 1950 Circle of Hope, Clinic 3a, Salt Lake City, UT 84112-5500 | 2006-05-08 |
1558892968 | Jennifer Lynne Mijangos | Social Worker | 1950 Circle of Hope, Huntsman Cancer Institute, Salt Lake City, UT 84112-9460 | 2017-03-27 |
1952857963 | Rachel Montague | Nurse Practitioner | 1950 Circle of Hope, 505 Clinic, Salt Lake City, UT 84112-5550 | 2016-08-30 |
1568828002 | Tenzin Kunsang Phunrab | Nurse Practitioner | 1950 Circle of Hope, Clinic 2b, Salt Lake City, UT 84112-5550 | 2016-01-13 |
1164891677 | Breanne Eddington | Physician Assistant | 1950 Circle of Hope, Hch 4th Floor, Salt Lake City, UT 84112-5550 | 2015-09-15 |
1619353182 | Jaclyn Jennifer Piper-williams | Nurse Practitioner | 1950 Circle of Hope, Sos Clinic, Salt Lake City, UT 84112-5550 | 2015-08-06 |
1356742233 | Jutta Deininger | Nurse Practitioner | 1950 Circle of Hope, Clinic 3a, Salt Lake City, UT 84112-5550 | 2014-09-10 |
1679974059 | Linda Sue Johnson | Nurse Practitioner | 1950 Circle of Hope, Hoh 4th Floor, Salt Lake City, UT 84112-5550 | 2014-09-04 |
1952710923 | Krista Casey | Physician Assistant | 1950 Circle of Hope, Hch 4th Floor, Salt Lake City, UT 84112-5550 | 2014-08-04 |
1093065385 | Jared Thomas Thorley | Nurse Practitioner | 1950 Circle of Hope, Clinic 2b, Salt Lake City, UT 84112-5550 | 2012-09-13 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508484023 | Courtney Hook | Student in an Organized Health Care Education/Training Program | 1860 E 250 S Hper East, Room 208, Salt Lake City, UT 84112 | 2020-07-10 |
1235792839 | Dylan Lamb | Rehabilitation Practitioner | 1850 S. 260 E, Salt Lake City, UT 84112 | 2019-04-18 |
1740787407 | David Bradley Patch | Student in an Organized Health Care Education/Training Program | University of Utah Hospital Dental Clinic #7, 50 N. Medical Dr., Salt Lake City, UT 84112 | 2018-04-10 |
1962949586 | Gina Whitehead | Nurse Practitioner | 10 South 2000 East, Salt Lake City, UT 84112 | 2017-01-20 |
1316493117 | Dana Friske | Specialist/Technologist | 290 S 1850 E, Room 103, Salt Lake City, UT 84112 | 2016-08-31 |
1548612435 | Frances Millett Johnson | Nurse Practitioner | 555 South Foothill Blvd, Suite 301, Salt Lake City, UT 84112 | 2016-07-05 |
1679920904 | Jason Lippman | Family Medicine | 555 S. Foothill Blvd., Ste. 301, Salt Lake City, UT 84112 | 2016-05-17 |
1447604335 | Joseph Mcbeth | Specialist/Technologist | 580 S. Guardsman Way, Salt Lake City, UT 84112 | 2016-04-18 |
1104213636 | Cameron Critchfield | Student in an Organized Health Care Education/Training Program | 26 South 2000 East, Suite 5900, Salt Lake City, UT 84112 | 2015-04-22 |
1942697933 | Jennifer Rose | Dentist | 50 N Medical Dr, University Hospital, Salt Lake City, UT 84112 | 2015-04-17 |
Find all providers in zip 84112 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174936140 | Elizabeth Shade Cardenas | Nurse Practitioner | 500 Foothill Drive #182h, Veterans Healthcare Administration, Salt Lake City, UT 84148 | 2014-06-08 |
1366737579 | Matrix Medical Network of Utah,llc | Nurse Practitioner | 2150 S 1300 E Ste 500, Salt Lake City, UT 84106-4375 | 2011-06-15 |
1265612097 | Solo Clinical Services LLC | Nurse Practitioner | 1864 Downington Ave, Salt Lake City, UT 84108-2912 | 2007-11-09 |
1730201245 | William Andrew Schwarz II | Nurse Practitioner | 4701 W 2100 S Bldg 3, C/o Cr England and Lakeside Medical Clinic, Salt Lake City, UT 84120-1223 | 2007-04-04 |
1700929338 | Cristine Tuttle | Nurse Practitioner | 375 Chipeta Way Suita A200, University of Utah Hospitals and Clinics, Sleep Center, Salt Lake City, UT 84108-0001 | 2007-02-14 |
1972650836 | Valerie Jean Flattes | Nurse Practitioner | Npha 4568 S Highland Drive, #290, Salt Lake City, UT 84117 | 2007-01-04 |
1184717878 | Kathleen Hooten | Nurse Practitioner | 555 Foothill Dr Rm 301, Salt Lake City, UT 84112-1106 | 2006-10-02 |
1841225372 | Janet E Tulloch | Nurse Practitioner | Va Slc Health Care Sytem 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2006-07-12 |
1770556946 | Jane Elizabeth Bell | Nurse Practitioner | George E Whalen Va Med Center (111p), 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2006-02-08 |
1639796477 | Lacey A Cooper | Nurse Practitioner | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-06-27 |
Find all providers in SALT LAKE CITY |
City | SALT LAKE CITY |
Zip Code | 84112 |
Please comment or provide details below to improve the information on JENNIFER SMITH SHAW.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.