Active NPI
Colton Phippen
- Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
- Provo, UT
National Provider Identifier
1144646613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
- License
- 142983349-1204
- Practice address
- 395 W Cougar Blvd Ste 102
Provo, UT 84604-3334 - Phone
- (801) 357-8586
- NPI assigned
- Mar 8, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MRO-2184 | ID | |
| Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician | 2081H0002X | 142983349-1204 | UT | Primary |
Addresses
Primary practice location
395 W Cougar Blvd Ste 102
Provo, UT 84604-3334
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other practice location 1
501 S Chipeta Way
Salt Lake City, UT 84108-1222
Phone (801) 236-7710
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC / Office Ally |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- cphippen702074@ahs.direct-ci.com
- colton.phippen.1@13153.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785801600000",
"number": "1144646613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "395 W COUGAR BLVD STE 102",
"city": "PROVO",
"state": "UT",
"postal_code": "846043334",
"telephone_number": "801-357-8586"
}
],
"practiceLocations": [
{
"address_1": "501 S Chipeta Way",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841081222",
"country_code": "US",
"telephone_number": "801-236-7710",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHIPPEN",
"first_name": "COLTON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-08",
"last_updated": "2026-08-04",
"certification_date": "2026-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "MRO-2184",
"primary": false
},
{
"code": "2081H0002X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Hospice and Palliative Medicine",
"state": "UT",
"license": "142983349-1204",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC / Office Ally",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.