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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

JACK CARLSON
NPI 1114844370
Student in an Organized Health Care Education/Training Program in Salt Lake City, UT

Active since June 30, 2026
27 S MARIO CAPECCHI DR, SALT LAKE CITY, UT 84112(952) 540-7975 Get Directions Write a Review

NPPES record added: June 30, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jack Carlson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK CARLSON (NPI 1114844370) is an individual student in an organized health care education/training program in Salt Lake City, Utah, licensed in Utah (390200000X) and active in the NPI registry since June 2026.

NPPES Registry Identity

NPI1114844370
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACK CARLSON
Location Address27 S MARIO CAPECCHI DRSalt Lake City, UT 84112-5888
Mailing Address27 S Mario Capecchi DrSalt Lake City, UT 84112-5888
Phone(952) 540-7975
Sole ProprietorYes
Enumeration DateJune 30, 2026
NPPES CertifiedJune 30, 2026
✔ NPI 1114844370 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in UT · 390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

27 S MARIO CAPECCHI DR, Salt Lake City, UT 84112
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADISON FISHER
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-7498
ALEXANDRA SARAH VITALE
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SLC, UT 84112
Salt Lake County (801) 213-9500
BRYAN RADMALL
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-7489
DANIELLE MARIE KELLY
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112
Salt Lake County (801) 425-8189
KARLI V LUDWIG MD
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-6437
KADE WAGERS MK
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-7498
AZRAA SAMIN AYESHA MD
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-2121
GEORGIA VEVERKA
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-7498

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Carlson's NPI number?

The NPI number for Jack Carlson is 1114844370. It was assigned to this individual provider in the NPPES registry on June 30, 2026.

Where is Jack Carlson located?

Jack Carlson practices at 27 S Mario Capecchi Dr, Salt Lake City, UT 84112. The listed phone number is (952) 540-7975.

What is Jack Carlson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Jack Carlson was last updated on June 30, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.