DR. JONATHAN MICHAEL NEILSON (DNP) – Pediatric Nurse Practitioner, NPI 1780236109
Pediatric Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. JONATHAN MICHAEL NEILSON (DNP)
11447 S CHARTER POINTE RD
SOUTH JORDAN, UT 840957924
Phone: (801) 803-3855
Type: Mailing
Mario Capecchi Drive, Salt Lake City, Salt Lake County, Utah, 84412, United States
SALT LAKE CITY, UT 841131103
Phone: (801) 662-3300
Type: Location
3336 S 4155 W
West Valley City, UT 84120
Phone: (801) 912-9700
Fax: (801) 912-9710
Type: Location
7181 S CAMPUS VIEW DR STE 200
WEST JORDAN, UT 840844312
Phone: (801) 965-3505
Type: Mailing
2965 W 3500 S
WEST VALLEY CITY, UT 841193602
Phone: (801) 965-3600
Type: Mailing
12391 S 4000 W
RIVERTON, UT 840967012
Phone: (801) 302-1700
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $170.
Total Amount is formed as General ($170) + Research ($0) + Ownership ($0) = $170.
Last reported payment date: 2024-09-04 • Largest payer in this snapshot: IRONSHORE PHARMACEUTICALS INC. ($54).
Total Amount
$170
General + Research + Ownership
Payments
9
Total payment records
General Amount
$170
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| IRONSHORE PHARMACEUTICALS INC. | $54 |
| SANOFI PASTEUR INC. | $53 |
| ABBVIE INC. | $21 |
| SOBI, INC | $16 |
| GlaxoSmithKline, LLC. | $13 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-10-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20201021000570 | I | Nurse Practitioner | UT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84095)
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