Individual provider Active NPI

Matthew Allred, A.P.R.N.

  • Nurse Practitioner
  • West Jordan, UT
National Provider Identifier
1194262022
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7765348-4405 Issued in UT
Practice address
3584 W 9000 S
Suite 405
West Jordan, UT 84088-5710
Phone
(801) 568-3480
Fax
(801) 562-3140
NPI assigned
Jan 30, 2017
Last updated
Aug 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 7765348-4405 UT Primary
Family Nurse Practitioner 363LF0000X 7765348-4408 UT

Addresses

Primary practice location

3584 W 9000 S
Suite 405
West Jordan, UT 84088-5710

Mailing address

3584 W 9000 S
Suite 405
West Jordan, UT 84088-5710
Phone (801) 568-3480

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
I20170512001422 UT Practitioner - Nurse Practitioner 2769769157 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

3584 W 9000
Suite 405
West Jordan, UT 84088-5712
Phone (801) 568-3480

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Group of Utah Inc CurrentSince Mar 28, 2017 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince May 1, 2023 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince May 1, 2023 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients

Locations

82 S 1100 E
Ste 103
Salt Lake Cty, UT 84102
Phone (801) 505-5370

2530 W 4700 S
Ste B8
Taylorsville, UT 84129
Phone (801) 967-5866

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

3584 W 9000 S
Ste 405
West Jordan, UT 84088
Phone (801) 568-3480

Networks

  • UT PPO D-SNP
  • UT PPO

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 1

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": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1194262022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3584 W 9000 S",
            "address_2": "SUITE 405",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840885710",
            "telephone_number": "801-568-3480",
            "fax_number": "801-562-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3584 W 9000 S",
            "address_2": "SUITE 405",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840885710",
            "telephone_number": "801-568-3480",
            "fax_number": "801-562-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLRED",
        "first_name": "MATTHEW",
        "credential": "A.P.R.N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-30",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "7765348-4405",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "7765348-4408",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

Verify at the official NPI Registry.