Individual provider Active NPI

Dustin Keith Jones, APRN

  • Family Nurse Practitioner
  • Riverton, UT
National Provider Identifier
1083274724
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7203996-4405 Issued in UT
Practice address
1756 W Park Ave
Riverton, UT 84065-4701
Phone
(801) 254-0309
NPI assigned
Jun 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7203996-4405 UT Primary

Addresses

Primary practice location

1756 W Park Ave
Riverton, UT 84065-4701

Mailing address

1756 W Park Ave
Riverton, UT 84065-4701
Phone (801) 893-1905

Other practice location 1

4095 E Pony Express Pkwy Ste 1
Eagle Mountain, UT 84005-5531
Phone (801) 429-8037

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
I20190820001824 UT Practitioner - Nurse Practitioner 2567790215 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7203996-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Jan 3, 2023 Accepting new patients
Revere Health PC CurrentSince Jan 3, 2023 Accepting new patients

Locations

4095 E Pony Express Pkwy
Ste 1
Eagle Mountain, UT 84005
Phone (801) 429-8037

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1756 W Park Ave
Riverton, UT 84065
Phone (801) 254-0309

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1083274724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1756 W PARK AVE",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840654701",
            "telephone_number": "801-893-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1756 W PARK AVE",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840654701",
            "telephone_number": "801-254-0309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4095 E Pony Express Pkwy Ste 1",
            "address_purpose": "LOCATION",
            "city": "Eagle Mountain",
            "state": "UT",
            "postal_code": "840055531",
            "country_code": "US",
            "telephone_number": "801-429-8037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "DUSTIN",
        "middle_name": "KEITH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-15",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "7203996-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

Verify at the official NPI Registry.