NPIMap

Individual provider Active NPI

Brittney Andersen, APRN

  • Nurse Practitioner
  • Draper, UT
National Provider Identifier
1174831408
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
61133094405 Issued in UT
Practice address
12433 Fort St
Draper, UT 84020-9363
Phone
(801) 576-1086
Fax
(801) 576-9796
NPI assigned
Sep 21, 2010
Last updated
Jan 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 61133094405 UT Primary

Addresses

Primary practice location

12433 Fort St
Draper, UT 84020-9363

Mailing address

12433 Fort St
Draper, UT 84020-9363
Phone (801) 576-1086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130104000131 UT Practitioner - Nurse Practitioner 4688862360 Reassigns benefits to 1 organization
Practice locations: Layton, UT

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1133 N Main St
Suite 210
Layton, UT 84041-4873
Phone (435) 512-0353

1133 N Main St
Suite 300
Layton, UT 84041-4800
Phone (801) 513-5173

1133 N Main St
Suite 300
Layton, UT 84041-5339

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
14.65 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
48.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61133094405UTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Injury Care Nurse Practitioner PastSince Nov 18, 2012 Accepting new patients
Afi Hospice LLC Family Medicine PastSince Aug 31, 2010 Accepting new patients
Country Lane Payson Operating LLC Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1174831408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12433 FORT ST",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209363",
            "telephone_number": "801-576-1086",
            "fax_number": "801-576-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12433 FORT ST",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209363",
            "telephone_number": "801-576-1086",
            "fax_number": "801-576-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "BRITTNEY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-21",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "61133094405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

Verify at the official NPI Registry.