CALEB JACKSON


Address: 1220 E 3900 S, Ste 4e, Salt Lake City, UT 84124-1377
Phone: 8012618507

CALEB JACKSON (NPI# 1275926149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1275926149
Entity Type Individual
Full Name CALEB JACKSON
Credential FNP
Practice Address 1220 E 3900 S
Ste 4e
Salt Lake City
UT 84124-1377
Practice Telephone 8012618507
Practice Fax Number 8012618511
Mailing Telephone 8012618507
Mailing Fax Number 8012618511
Enumeration Date 2015-03-16
Last Update Date 2015-07-01
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
347183-4405 UT Physician Assistants & Advanced Practice Nursing Providers

Other Providers CALEB JACKSON

NPI Name Taxonomy Address Enumeration
1598270142 Caleb Jackson Specialist 2 Wall St Ste 400, Manchester, NH 03101 2017-12-05

Office Location

Street Address 1220 E 3900 S
STE 4E
City SALT LAKE CITY
State UT
Zip Code 84124-1377

Providers in the same location

NPI Name Taxonomy Address Enumeration
1689671737 Chris Lindsey Physician Assistant 1220 E 3900 S, # 4e, Salt Lake City, UT 84124-1327 2005-07-05
1013317361 Jonathan Middlemiss Physician Assistant 1220 E 3900 S, Ste 4e, Salt Lake City, UT 84124-1377 2014-08-23
1568700177 Scott A Leckman Md Facs PC Surgery 1220 E 3900 S, Suite 3g, Salt Lake City, UT 84124-1377 2013-01-17
1578859831 Mountainstar Medical Group Neurosurgery - St Marks LLC Neurological Surgery 1220 E 3900 S, Ste. 4-e, Salt Lake City, UT 84124-1377 2011-06-24
1487976866 Utah Cancer Institute, LLC Surgery 1220 E 3900 S, Suite 4f, Salt Lake City, UT 84124-1377 2010-02-25
1922339373 Jill E Clark Md PC Colon & Rectal Surgery 1220 E 3900 S, Ste 4i, Salt Lake City, UT 84124-1377 2010-01-26
1306016712 Richard Schwartz Md PC Neurological Surgery 1220 E 3900 S, Suite 4e, Salt Lake City, UT 84124-1327 2008-03-03
1619190899 Mt. Olympus Obstetrics and Gynecology Obstetrics & Gynecology 1220 E 3900 S, Suite 3e, Salt Lake City, UT 84124-1327 2007-04-10
1952450074 Kurt Christensen Crna PC Nurse Anesthetist, Certified Registered 1220 E 3900 S, Salt Lake City, UT 84124-1327 2007-01-09
1538226295 Richard G Watts Anesthesia Inc Nurse Anesthetist, Certified Registered 1220 E 3900 S, 4g, Salt Lake City, UT 84124-1327 2007-01-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1487273298 Shannon Penny Price Social Worker 4465 Maybeck Place, Condo C, Millcreek, UT 84124 2020-04-11
1922654367 Joseph C Melvin Md PC Colon & Rectal Surgery 1250 East 3900 South Ste 320, Salt Lake City, UT 84124 2019-08-12
1366923252 Melanie Stumpf Counselor 1141 E 3900, Suite A170, Salt Lake City, UT 84124 2018-08-28
1376033993 Michelle Flowers Speech-Language Pathologist 2120 East 3900 South, Ste 200, Holladay, UT 84124 2018-05-18
1740797257 Lissa Anne Hutchings Nurse Practitioner 1160 E 3900 S Ste 4100, Salt Lake City, UT 84124 2018-01-05
1316465693 Randy Gines Counselor 4460 S Highland Drive # 230, Murray, UT 84124 2017-09-06
1417470717 Joshua Chandler Spencer Counselor 4460 South Highland Dr., 230, Murray, UT 84124 2017-07-19
1659891554 Marcus Whitney Counselor 4460 S Highland Dr. # 230, Murray, UT 84124 2017-06-21
1518496884 Courtney Nilson Counselor 4460 S. Highland Dr. #230, Murray, UT 84124 2017-06-08
1841687126 Intrafilrx Preferred Provider Organization 3920 S 1100 E Ste 210, Salt Lake City, UT 84124 2015-04-23
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982204590 Gabrielle Sleater Lewis Nurse Practitioner 2905 S Mcclelland St, Salt Lake City, UT 84106-2125 2020-11-01
1962019596 Freya Kristen Landesman Nurse Practitioner 60 E South Temple Ste 300, Salt Lake City, UT 84111-1041 2020-09-28
1568075604 Michelle L Davis Nurse Practitioner 24 S 1100 E Ste 305, Salt Lake City, UT 84102-4500 2020-08-28
1518583988 Melanie Elise Harris Nurse Practitioner 1250 E 3900 S Ste 301, Salt Lake City, UT 84124-1350 2020-06-22
1295359651 Julie Nielsen Nurse Practitioner 1170 E Westminster Ave Apt C, Salt Lake City, UT 84105-3514 2020-06-02
1770112138 Justin Henderson Nurse Practitioner 3851 S Birch Dr, Salt Lake City, UT 84109-3742 2020-04-07
1346885845 Anita Hui Lucente Nurse Practitioner 1111 E Brickyard Rd, Salt Lake City, UT 84106-2560 2019-11-08
1841844057 Mayra Ibeth Vences Nurse Practitioner 1146 N Antilles Dr, Salt Lake City, UT 84116-4656 2019-07-25
1710549928 Jenny Farley Mason Nurse Practitioner 4179 S Monarch Way, Salt Lake City, UT 84124-3168 2019-07-08
1144889940 Amy Jackson Gilbert Nurse Practitioner 1950 Circle of Hope Dr Rm 4146, Salt Lake City, UT 84112-5500 2019-06-06
Find all providers in SALT LAKE CITY

Competitor

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City SALT LAKE CITY
Zip Code 84124

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Dataset Information

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.

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