Active NPI
Shellie R Crossett, FNP
- Family Nurse Practitioner
- Salt Lake City, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 285455-4405
- Practice address
- 100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103 - Phone
- (801) 662-1000
- NPI assigned
- Oct 1, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 285455-4405 | UT | Primary |
Addresses
Primary practice location
100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Mailing address
100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (801) 662-1000
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210614002991 | UT | Practitioner - Nurse Practitioner | 8325448277 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 285455-4405 | UT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Internal Medicine | Current | Accepting new patients |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
5169 S Cottonwood St
Ste 500
Salt Lake City, UT 84107
Phone (801) 507-5152
400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080
5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998
100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Murray, UT
- NPI 1629260880
Internal Medicine, UT
-
- Multi-Specialty Clinic/Center
- Murray, UT
- NPI 1689976532
-
- Psychiatry Physician
- Provo, UT
- NPI 1871847434
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
5121 S Cottonwood St
Murray, UT 84107-5701
Phone (801) 507-7000
5169 S Cottonwood St
Suite 500
Murray, UT 84107-6770
Phone (801) 507-5152
Hospital & facility affiliations
- American Fork Hospital
- Intermountain Health Alta View Hospital
- Intermountain Health Riverton Hospital
- Park City Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285891200000",
"number": "1215246731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROSSETT",
"first_name": "SHELLIE",
"middle_name": "R",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-01",
"last_updated": "2010-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "UT",
"license": "285455-4405",
"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 Oct 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.