Individual provider Active NPI

Susan B Hastings, PA-C

  • Physician Assistant
  • Kaysville, UT
National Provider Identifier
1073501086
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
214662-1206 Issued in UT
Practice address
275 W 200 N Ste 7
Kaysville, UT 84037-1873
Phone
(801) 546-1300
Fax
(801) 546-1301
NPI assigned
Oct 12, 2005
Last updated
Sep 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 214662-1206 UT Primary

Addresses

Primary practice location

275 W 200 N Ste 7
Kaysville, UT 84037-1873

Mailing address

275 W 200 N Ste 7
Kaysville, UT 84037-1873
Phone (801) 546-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
214662-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ogden Clinic Specialty Services LLC Physician Assistant Current Accepting new patients
Life Spring Pain Management, LLC PastSince Sep 16, 2013 Accepting new patients
C and B Family Practice LLC Past Accepting new patients

Locations

1159 12th St
Ogden, UT 84404
Phone (801) 475-3700

4650 Harrison Blvd
Ogden, UT 84403
Phone (801) 475-3481

5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

Organizations & group practices 3

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1073501086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W 200 N STE 7",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371873",
            "telephone_number": "801-546-1300",
            "fax_number": "801-546-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W 200 N STE 7",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371873",
            "telephone_number": "801-546-1300",
            "fax_number": "801-546-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASTINGS",
        "first_name": "SUSAN",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "214662-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaysville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.