Active NPI
Amanda C Van Gils, PA-C
- Physician Assistant
- Salt Lake City, UT
National Provider Identifier
1215186077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5742442-1206
- Practice address
- 1365 W 1000 N
Salt Lake City, UT 84116-1654 - Phone
- (801) 328-5750
- Fax
- (801) 521-7463
- NPI assigned
- Sep 16, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5742442-1206 | UT | Primary |
Addresses
Primary practice location
1365 W 1000 N
Salt Lake City, UT 84116-1654
Mailing address
1365 W 1000 N
Salt Lake City, UT 84116-1654
Phone (801) 328-5750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5742442-1206 | UT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221523200000",
"number": "1215186077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1365 W 1000 N",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841161654",
"telephone_number": "801-328-5750",
"fax_number": "801-521-7463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1365 W 1000 N",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841161654",
"telephone_number": "801-328-5750",
"fax_number": "801-521-7463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN GILS",
"first_name": "AMANDA",
"middle_name": "C",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-16",
"last_updated": "2008-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "5742442-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.