Active NPI
Bremond White, FNP-BC
- Nurse Practitioner
- Lehi, UT
National Provider Identifier
1023696341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 381082-4405
- Practice address
- 4151 N Traverse MTN Blvd # 19-001
Lehi, UT 84043-2616 - Phone
- (801) 440-0260
- NPI assigned
- Mar 30, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 381082-4405 | UT | Primary |
Addresses
Primary practice location
4151 N Traverse MTN Blvd # 19-001
Lehi, UT 84043-2616
Mailing address
4151 N Traverse MTN Blvd # 19-001
Lehi, UT 84043-2616
Phone (801) 440-0260
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 381082-4405 | UT | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617062400000",
"number": "1023696341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4151 N TRAVERSE MTN BLVD # 19-001",
"city": "LEHI",
"state": "UT",
"postal_code": "840432616",
"telephone_number": "801-440-0260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4151 N TRAVERSE MTN BLVD # 19-001",
"city": "LEHI",
"state": "UT",
"postal_code": "840432616",
"telephone_number": "801-440-0260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "BREMOND",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-30",
"last_updated": "2021-03-30",
"certification_date": "2021-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "UT",
"license": "381082-4405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lehi, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.