Brynnley Sue Mair – Physician Assistant in Nibley, UT

Key facts

NPI: 1114669298
Entity type: Individual (NPI type 1)
Primary specialty: Physician Assistant 363A00000X
License: 14168104-1206 (UT)
Practice address: 389 Sheridan Cir
Nibley, UT 84321-7646
Phone: (435) 770-5616
NPI assigned: Apr 10, 2022
Sex: Female
Sole proprietor: Yes

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.

Ihc Health Services Inc Multi-Specialty Clinic/Center · Sandy, UT · NPI 1942325154

Medicare reassignment UT
Ihc Health Services Inc Cardiovascular Disease Physician · Logan, UT · NPI 1801114459

NPD SINGLE SPECIALTY
Ihc Health Services, Inc. Psychiatry Physician · St George, UT · NPI 1023843844

NPD

Hospital & facility affiliations 1

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

Ihc Health Services Inc General Acute Care Hospital · Logan, UT · NPI 1831108497

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Physician Assistant
Education: Other, 2024
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Ihc Health Services Inc (3,948 clinicians)

Practice addresses (Care Compare)

1350 N 500
Logan, UT 84341-2400
Phone (435) 716-1958

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

Intermountain Health Logan Regional Hospital Hospital · Logan, UT · CCN 460015

Medicare participation

Medicare fee-for-service enrollment: Enrolled in UT
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
I20241025001622	UT	Practitioner - Physician Assistant	6103359468	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Physician Assistant

State licenses

License	State	Type	Specialty
14168104-1206	UT	MD	Physician Assistant

Practice roles

Organization	Specialty	Status	New patients
Ihc Health Services, Inc.		Current since Nov 10, 2024	Accepting new patients
Ihc Health Services Inc	Single Specialty	Current since Nov 10, 2024	Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1350 N 500 E
North Logan, UT 84341
Phone (435) 716-2800

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physician Assistant Group: 193400000X SINGLE SPECIALTY GROUP	363A00000X	14168104-1206	UT	Yes

Addresses

Primary practice location

389 Sheridan Cir
Nibley, UT 84321-7646

Mailing address

389 Sheridan Cir
Nibley, UT 84321-7646
Phone (435) 770-5616

Other providers in Nibley, UT

Homerun Crisis Intervention Services LLC
Treana Hunt
Jacqueline Johnson
Adaleen Krambule, CMHC
Sandy Krambule, LMFT
Kirsten Maughan, R.D.
Constance McDonald, LCSW
Michelle C McKnight, PHD, LPC, CRC
Sophie Norton
Jeffrey D Openshaw, MFT

All providers in Nibley, 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 Sep 21, 2024. 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.

Verify at the official NPI Registry.