1. Home
  2. Directory
  3. Utah
  4. Salt Lake City
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

JORDAN KEVIN JOHNSON
NPI 1174222186
Student in an Organized Health Care Education/Training Program in Salt Lake City, UT

Active since February 28, 2023PECOS Enrolled
27 S MARIO CAPECCHI DR, SALT LAKE CITY, UT 84112(801) 836-3226 Get Directions Write a Review

NPPES record last updated: February 28, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jordan Kevin Johnson NPPES

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

JORDAN KEVIN JOHNSON (NPI 1174222186) is an individual student in an organized health care education/training program in Salt Lake City, Utah and active in the NPI registry since February 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174222186
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJORDAN KEVIN JOHNSON
Location Address27 S MARIO CAPECCHI DRSalt Lake City, UT 84112-5888
Mailing Address27 S Mario Capecchi DrSalt Lake City, UT 84112-5888 · (801) 836-3226
Phone(801) 836-3226
Sole ProprietorNo
Enumeration DateFebruary 28, 2023
NPPES CertifiedFebruary 28, 2023
✔ NPI 1174222186 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
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
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jordan Kevin Johnson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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 Jordan Johnson's NPI number?

The NPI number for Jordan Johnson is 1174222186. It was assigned to this individual provider in the NPPES registry on February 28, 2023.

Where is Jordan Johnson located?

Jordan Johnson practices at 27 S Mario Capecchi Dr, Salt Lake City, UT 84112. The listed phone number is (801) 836-3226.

What is Jordan Johnson's specialty?

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

Is Jordan Johnson enrolled in Medicare?

Yes. Jordan Johnson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jordan Johnson was last updated on February 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.