Individual provider Active NPI

James Edward Fenton Jr., FNP

  • Family Nurse Practitioner
  • Clearfield, UT
National Provider Identifier
1114579596
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11425353-4405 Issued in UT
Practice address
600 S State St Ste 2
Clearfield, UT 84015-1210
Phone
(385) 483-1003
Fax
(386) 222-7279
NPI assigned
Jul 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A155585 IA
Family Nurse Practitioner 363LF0000X 209.019352 IL
Family Nurse Practitioner 363LF0000X 11425353-4405 UT Primary

Addresses

Primary practice location

600 S State St Ste 2
Clearfield, UT 84015-1210

Mailing address

3841 Westwood Dr
Pleasant View, UT 84414-1319
Phone (217) 779-3606

Other practice location 1

612 Main St
Keokuk, IA 52632-5450
Phone (319) 524-3339

Other practice location 2

612 Main St
Keokuk, IA 52632-5450
Phone (319) 524-3339

Other practice location 3

2351 Grant Ave Ste 201
Ogden, UT 84401
Phone (801) 317-8099

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
I20191218001524 UT Practitioner - Nurse Practitioner 5799119137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MMG LLCGroup PAC ID 5991039489, 7 clinicians

Practice addresses (Care Compare)

302 W 5400
Suite 200
Murray, UT 84107-8230
Phone (801) 456-2333

Hospital & facility affiliations

  • Canyon Home Care Home health agency, Murray, UT, CCN 467226
  • Ability Home Health Home health agency, South Jordan, UT, CCN 467238
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A155585IAMDFamily Nurse Practitioner
209.019352ILMDFamily Nurse Practitioner
11425353-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MMG LLC CurrentSince Apr 14, 2023 Accepting new patients
MMG LLC CurrentSince Apr 14, 2023 Accepting new patients

Locations

302 W 5400 S
Ste 201
Salt Lake City, UT 84107
Phone (801) 456-2333

302 W 5400 S
Ste 200
Salt Lake City, UT 84107
Phone (385) 297-9500

746 E Winchester St
Ste 230B
Salt Lake City, UT 84107
Phone (801) 456-2333

Interoperability endpoints

  • Direct secure messaging: james.fenton.1@28984.direct.athenahealth.com
  • Direct secure messaging: james.fenton@epsl-ut.direct.office.nextgen.com

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1114579596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 WESTWOOD DR",
            "city": "PLEASANT VIEW",
            "state": "UT",
            "postal_code": "844141319",
            "telephone_number": "217-779-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S STATE ST STE 2",
            "city": "CLEARFIELD",
            "state": "UT",
            "postal_code": "840151210",
            "telephone_number": "385-483-1003",
            "fax_number": "386-222-7279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "612 Main St",
            "address_purpose": "LOCATION",
            "city": "Keokuk",
            "state": "IA",
            "postal_code": "526325450",
            "country_code": "US",
            "telephone_number": "319-524-3339",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "612 Main St",
            "address_purpose": "LOCATION",
            "city": "Keokuk",
            "state": "IA",
            "postal_code": "526325450",
            "country_code": "US",
            "telephone_number": "319-524-3339",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2351 Grant Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "84401",
            "country_code": "US",
            "telephone_number": "801-317-8099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENTON",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-15",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A155585",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.019352",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11425353-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearfield, UT

Sources for this page

Verify at the official NPI Registry.