Individual provider Active NPI

Sabrina Rae Williams, PA-C

  • Physician Assistant
  • Murray, UT
National Provider Identifier
1225562259
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10095607-1206 Issued in UT
Practice address
5121 S Cottonwood St
Murray, UT 84107-5701
Phone
(801) 507-7000
NPI assigned
Apr 17, 2017
Last updated
Apr 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10095607-1206 UT Primary

Addresses

Primary practice location

5121 S Cottonwood St
Murray, UT 84107-5701

Mailing address

1550 Lakeview Way
Ogden, UT 84403-1427
Phone (562) 328-9894

Other names 1

  • Sabrina Rae Rebollar Former name

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
I20180329000274 UT Practitioner - Physician Assistant 2961764089 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Feb 20, 2018 Accepting new patients
Ihc Health Services Inc CurrentSince Feb 20, 2018 Accepting new patients

Locations

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

5171 S Cottonwood St
Ste 210
Salt Lake City, UT 84107

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

Organizations & group practices 3

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": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492387200000",
    "number": "1225562259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 LAKEVIEW WAY",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844031427",
            "telephone_number": "562-328-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "801-507-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SABRINA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2017-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "10095607-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SABRINA",
            "last_name": "REBOLLAR",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.