Individual provider Active NPI

Jaycee Lyn Fausett

  • Nurse Practitioner
  • Orem, UT
National Provider Identifier
1033990908
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10514537-4405 Issued in UT
Practice address
153 N 400 W
St B-6
Orem, UT 84057
Phone
(801) 921-2260
NPI assigned
Oct 9, 2023
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10514537-4405 UT Primary

Addresses

Primary practice location

153 N 400 W
St B-6
Orem, UT 84057

Mailing address

153 N 400 W
St B-6
Orem, UT 84057
Phone (801) 616-0066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240213000278 UT Practitioner - Nurse Practitioner 9638512049 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
A&C Johnston LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

153 N 400 W
Orem, UT 84057
Phone (801) 921-2260

153 N 400 W
#B6
Orem, UT 84057
Phone (801) 921-2260

895 W Center St
Orem, UT 84057
Phone (801) 221-1220

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1033990908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 N 400 W",
            "address_2": "ST B-6",
            "city": "OREM",
            "state": "UT",
            "postal_code": "84057",
            "telephone_number": "801-616-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 N 400 W",
            "address_2": "ST B-6",
            "city": "OREM",
            "state": "UT",
            "postal_code": "84057",
            "telephone_number": "801-921-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUSETT",
        "first_name": "JAYCEE",
        "middle_name": "LYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "10514537-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

Verify at the official NPI Registry.