Individual provider Active NPI

Camille Diana Giles, FNP-C

  • Nurse Practitioner
  • South Jordan, UT
National Provider Identifier
1235879891
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5487196-4405 Issued in UT
Practice address
11520 S Redwood Rd
South Jordan, UT 84095-7805
Phone
(385) 887-6000
NPI assigned
Mar 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 54871964405 UT
Nurse Practitioner 363L00000X 5487196-4405 UT Primary

Addresses

Primary practice location

11520 S Redwood Rd
South Jordan, UT 84095-7805

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

1531 E 575 N
Layton, UT 84040-3636
Phone (801) 821-6221

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
I20220822000921 UT Practitioner - Nurse Practitioner 4880077064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
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)

11520 S Redwood Rd
South Jordan, UT 84095-7805
Phone (385) 887-7300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5487196-4405UTMDNurse Practitioner
54871964405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Family Medicine CurrentSince Jul 18, 2022 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jul 18, 2022 Accepting new patients

Locations

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

11520 S Redwood Rd
South Jordan, UT 84095
Phone (385) 887-6000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1235879891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11520 S REDWOOD RD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840957805",
            "telephone_number": "385-887-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1531 E 575 N",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840403636",
            "country_code": "US",
            "telephone_number": "801-821-6221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILES",
        "first_name": "CAMILLE",
        "middle_name": "DIANA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "54871964405",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "5487196-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

Verify at the official NPI Registry.