Jeffrey Scott Walsh
Nurse Practitioner, Primary Care in Bountiful, UT. Individual provider (NPI-1).
NPI number1962070102
StatusActive
Last updated in NPPESAug 26, 2022
Details
- NPI
- 1962070102
- Entity type
- Individual (NPI-1)
- Name
- Jeffrey Scott Walsh
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 15, 2021
- Certification date
- Aug 26, 2022
- Last updated
- Aug 26, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP2300X | Nurse Practitioner, Primary Care | 10676959-4405 | UT | Yes |
| 163WG0000X | Registered Nurse, General Practice | 10676959-3102 | UT |
Practice location
542 E 1600 SBountiful, UT 84010-4016
Phone 801-979-4077
Mailing address
542 E 1600 SBountiful, UT 84010-4016
Phone 801-979-4077
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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