Tenille Marshane Anderson
Individual provider Active NPI Physician Assistant · Cedar City, UT
NPI 1144960378 · NPPES record last updated May 21, 2025
Key facts
- NPI
- 1144960378
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1228258 (UT)
- Practice address
- 110 W 1325 N Ste 200
Cedar City, UT 84721-8179 - Phone
- (435) 586-7676
- NPI assigned
- Mar 29, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cedar Ridge Family Medicine
Practice addresses (Care Compare)
110 W 1325
Suite 200
Cedar City, UT 84721-8179
Phone (435) 586-7676
Hospital & facility affiliations
- Intermountain Health Cedar City Hospital
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 |
|---|---|---|---|---|
| I20250226003655 | UT | Practitioner - Physician Assistant | 7618497132 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1228258 | UT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gadzoom Health LLC | Physician Assistant | Current |
Accepting new patients |
Locations
3401 N Thanksgiving Way
Ste 190
Lehi, UT 84048
Phone (385) 454-5027
Interoperability endpoints
- https://api.platform.athenahealth.com/22054/brand/1/csg/1/fhir/r4
- tenille.anderson.1@22054.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1228258 | UT | Yes |
Addresses
Primary practice location
110 W 1325 N Ste 200
Cedar City, UT 84721-8179
Mailing address
110 W 1325 N Ste 200
Cedar City, UT 84721-8179
Phone (435) 586-7676
Other providers in Cedar City, UT
- Casey Anderson
- Chad W. Anderson
- Christine Anderson
- Jaidey Anderson
- Lisa Vernon Anderson
- Kirk J Anderton
- Hanna Angell
- Jason Arch
- William David Armour III
- Paul S Arnold
All providers in Cedar City, 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 May 21, 2025. 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.