Jennifer B Littledike, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

210 Millpond
Stansbury Park, UT 84074-8187

Phone

(435) 843-3647

NPI assigned

Sep 7, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

University of Utah School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shaun Gundersen FNP PLLCGroup PAC ID 6507251782, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain West Medical Center Hospital, Tooele, UT, CCN 460014

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25689/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/3781/brand/1/csg/1/fhir/r4
• Direct secure messaging: jennifer.littledike.1@25689.direct.athenahealth.com

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.

• Shaun Gundersen FNP, PLLC

  • Nurse Practitioner
  • Grantsville, UT
  • NPI 1457002503
  Medicare reassignment Care Compare group
• Patrick Green MD PLLC

  • Primary Care Clinic/Center
  • Tooele, UT
  • NPI 1518256650
  Medicare reassignment NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tooele Hospital Corporation

  • General Acute Care Hospital
  • Tooele, UT
  • NPI 1124090659
  Care Compare affiliation

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1063729481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 MILLPOND",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "840748187",
            "telephone_number": "435-843-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MILLPOND",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "840748187",
            "telephone_number": "435-843-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLEDIKE",
        "first_name": "JENNIFER",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Kay
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• Samantha Leder
• Monica Lee, DPT
• Jenny Rebecca Leffler, LCSW
• Marianne Mabey, PHARMD
• Amanda Madrid, PA-C
• Bret Maiers, PT
• Gage Manzione, DPT
• Amber Margolis, LCSW

• Medical Physician Assistant in Stansbury Park, UT
• Providers in Stansbury Park, UT by specialty
• Medical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.