Individual provider Active NPI

Marla Morillo

  • Physician Assistant
  • American Fork, UT
National Provider Identifier
1184249385
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
124948361206 Issued in UT
Practice address
1159 E 200 N Ste 250
American Fork, UT 84003-2028
Phone
(801) 855-2980
NPI assigned
Jun 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 124948361206 UT Primary

Addresses

Primary practice location

1159 E 200 N Ste 250
American Fork, UT 84003-2028

Mailing address

1159 E 200 N Ste 250
American Fork, UT 84003-2028
Phone (801) 855-2980

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
I20211021003263 UT Practitioner - Physician Assistant 4284022393 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1159 E 200
Suite 250
American Fork, UT 84003-2028
Phone (801) 855-2980

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
124948361206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Nov 6, 2022 Accepting new patients
Ihc Health Services, Inc. CurrentSince Nov 6, 2022 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

1159 E 200 N
Ste 250
American Fork, UT 84003
Phone (801) 855-2980

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

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1184249385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1159 E 200 N STE 250",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032028",
            "telephone_number": "801-855-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1159 E 200 N STE 250",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032028",
            "telephone_number": "801-855-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORILLO",
        "first_name": "MARLA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "124948361206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.