Individual provider Active NPI

James D. Crowley, PA-C

  • Physician Assistant
  • Payson, UT
National Provider Identifier
1104077817
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7127232-1206 Issued in UT
Practice address
39 Professional Way Ste 1
Payson, UT 84651-1676
Phone
(801) 465-4805
Fax
(801) 465-4354
NPI assigned
Oct 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 7127232-1206 UT Primary

Addresses

Primary practice location

39 Professional Way Ste 1
Payson, UT 84651-1676

Mailing address

1055 N 500 W
Credentialing Department
Provo, UT 84604-3305
Phone (801) 354-8225

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address medreview@reverehealth.com Revere Health PC

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
I20081111000526 UT Practitioner - Physician Assistant 6608935242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

700 W 800
Suite 400
Orem, UT 84057-6305
Phone (801) 375-3175

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Oct 6, 2008 Accepting new patients
Revere Health PC CurrentSince Oct 6, 2008 Accepting new patients

Locations

700 W 800 N
Ste 400
Orem, UT 84057
Phone (801) 221-8811

39 Professional Way
Payson, UT 84651
Phone (801) 465-4805

39 Professional Way
Ste 1
Payson, UT 84651
Phone (801) 465-4481

2230 N University Pkwy
Ste 9B
Provo, UT 84604
Phone (801) 375-3175

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

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

Interoperability endpoints

  • Direct secure messaging: jamescrowley@cuccu.allscriptsdirect.net

Organizations & group practices 2

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": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1104077817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 PROFESSIONAL WAY STE 1",
            "city": "PAYSON",
            "state": "UT",
            "postal_code": "846511676",
            "telephone_number": "801-465-4805",
            "fax_number": "801-465-4354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWLEY",
        "first_name": "JAMES",
        "middle_name": "D.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "7127232-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Revere Health PC",
            "address_1": "39 Professional Way Ste 1",
            "city": "Payson",
            "state": "UT",
            "country_code": "US",
            "postal_code": "846511676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Payson, UT

Sources for this page

Verify at the official NPI Registry.