JEFFREY SCOTT WALSH NPI 1962070102

NPI Information

  • NPI: 1962070102
  • Provider Name: JEFFREY SCOTT WALSH
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 542 E 1600 S
    BOUNTIFUL, UT
    ZIP 84010
  • Phone: (801) 979-4077

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NPI Details

Jeffrey Scott Walsh is a primary care nurse practitioner in Bountiful, UT with 4 years of experience. Jeffrey Scott Walsh NPI is 1962070102. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduation Year:2022

The provider's business location address is:

542 E 1600 S
BOUNTIFUL, UT
ZIP 84010-016
Phone: (801) 979-4077

The NPI 1962070102 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/15/2021 and was last updated on 8/26/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WG0000XRegistered NurseGeneral Practice10676959-3102UTAHNo
2363LP2300XNurse PractitionerPrimary Care10676959-4405UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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