Heather B Allred, PA-C
Individual provider Active NPI Physician Assistant · Providence, UT
NPI 1104859149 · NPPES record last updated Mar 14, 2023
Key facts
- NPI
- 1104859149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5536681-1206 (UT)
- Practice address
- 517 W 100 N Ste 103
Providence, UT 84332-9824 - Phone
- (435) 554-8442
- Fax
- (435) 500-9167
- NPI assigned
- Jul 9, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of Utah School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- LP Derm LLC
Draper Dermatology PC
Practice addresses (Care Compare)
1325 N 600
Suite 101
Logan, UT 84341-6743
Phone (435) 554-8442
1325 W S Jordan Pkwy
Suite 103
South Jordan, UT 84095-9060
Phone (801) 232-6556
517 W 100
Suite 103
Providence, UT 84332-9824
Phone (435) 554-8442
Hospital & facility affiliations
- Intermountain Health Logan Regional Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 74.28 of 100
- Quality
- 48.55
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in UT, WY, ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061006000410 | UT | Practitioner - Physician Assistant | 5092711481 | Reassigns benefits to 3 organizations |
| I20200908002506 | WY | Practitioner - Physician Assistant | 5092711481 | Reassigns benefits to 2 organizations |
| I20250227000996 | ID | Practitioner - Physician Assistant | 5092711481 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Lincoln Hospital District | Current |
Accepting new patients | |
| South Lincoln Hospital District | Current |
Accepting new patients | |
| Draper Dermatology, P.C. | Current |
Accepting new patients | |
| South Lincoln Hospital District | Past | Accepting new patients | |
| Alpine Management and Consulting | Past | Accepting new patients | |
| South Lincoln Hospital District | Past | Accepting new patients | |
| South Lincoln Hospital District | Past | Accepting new patients |
Locations
1325 W South Jordan Pkwy
Ste 103
South Jordan, UT 84095
Phone (801) 232-6556
195 Feather Way
Stop 100
Evanston, WY 82930
Phone (307) 200-9200
711 Onyx St
Kemmerer, WY 83101
Phone (307) 877-4401
Interoperability endpoints
- heather.allred.1@16971.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5536681-1206 | UT | Yes |
Addresses
Primary practice location
517 W 100 N Ste 103
Providence, UT 84332-9824
Mailing address
3240 N 1800 E
Logan, UT 84341-8312
Phone (801) 201-9151
Other practice location 1
711 Onyx St
Kemmerer, WY 83101-3214
Phone (307) 877-4401
Other practice location 2
1325 W South Jordan Pkwy Ste 103
South Jordan, UT 84095-9060
Phone (801) 390-4536
Other providers in Providence, UT
- Stanton Cannon Allen
- Talon Allen
- Allencrane, LLP
- Ty Bracken Aller
- Gregory J Allred
- Darren V Anderson
- Kent W Anderson
- Angel Home Hospice LLC
- Rachel Archibald
- Maeci Hicken Armstrong
All providers in Providence, UT · Physician Assistant in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.