Individual provider Active NPI

Ashlyn Rudd McClellan, FNP

  • Family Nurse Practitioner
  • South Jordan, UT
National Provider Identifier
1063239119
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14037948-4405 Issued in UT
Practice address
406 W South Jordan Pkwy Ste 450
South Jordan, UT 84095-3946
Phone
(801) 919-3008
NPI assigned
Sep 20, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 14037948-4405 UT Primary

Addresses

Primary practice location

406 W South Jordan Pkwy Ste 450
South Jordan, UT 84095-3946

Mailing address

1055 N 500 W Attn Credentialing
Provo, UT 84604
Phone (801) 354-8225

Other practice location 1

1055 N 500 W Ste 111
Provo, UT 84604-3305
Phone (801) 374-8999

Other practice location 2

1140 W Hidden Spring Dr
Santaquin, UT 84655-4665
Phone (801) 361-1408

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
I20250327003168 UT Practitioner - Nurse Practitioner 8729501077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Togo Healthcare LLCGroup PAC ID 2264973437, 9 clinicians

Practice addresses (Care Compare)

406 W S Jordan Pkwy
Suite 450
South Jordan, UT 84095-3946
Phone (801) 561-8398

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11636023-3102UTMDRegistered Nurse
14037948-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Togo Healthcare LLC Single Specialty CurrentSince Mar 1, 2025 Accepting new patients

Locations

406 W South Jordan Pkwy
Ste 450
South Jordan, UT 84095
Phone (801) 561-8398

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1063239119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W ATTN CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-354-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 W SOUTH JORDAN PKWY STE 450",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840953946",
            "telephone_number": "801-919-3008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 N 500 W Ste 111",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846043305",
            "country_code": "US",
            "telephone_number": "801-374-8999",
            "fax_number": "801-429-8063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1140 W Hidden Spring Dr",
            "address_purpose": "LOCATION",
            "city": "Santaquin",
            "state": "UT",
            "postal_code": "846554665",
            "country_code": "US",
            "telephone_number": "801-361-1408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "ASHLYN",
        "middle_name": "RUDD",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-20",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "14037948-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

Verify at the official NPI Registry.