Individual provider Active NPI

Wendy A Johnson, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Provo, UT
National Provider Identifier
1245422617
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
276738-4408 Issued in UT
Practice address
1034 N 500 W
Provo, UT 84604-3380
Phone
(801) 357-4992
Fax
(801) 357-7746
NPI assigned
Aug 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 276738-4408 UT Primary

Addresses

Primary practice location

1034 N 500 W
Provo, UT 84604-3380

Mailing address

1034 N 500 W
Provo, UT 84604-3380
Phone (801) 357-4992

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
I20090116000103 UT Practitioner - Nurse Practitioner 9638232655 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

1034 N 500
Provo, UT 84604-3380

3249 N 1200
Lehi, UT 84043-9772
Phone (801) 753-4300

395 W Bulldog Blvd
Provo, UT 84604-3331

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
276738-4408UTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Feb 6, 2013 Accepting new patients
Ihc Health Services Inc CurrentSince May 1, 2008 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. Psychiatry CurrentSince May 1, 2008 Accepting new patients

Locations

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

3249 N 1200 W
Lehi, UT 84043
Phone (801) 234-5880

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

395 W Cougar Blvd
Ste 601
Provo, UT 84604
Phone (801) 357-7525

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

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.

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1245422617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043380",
            "telephone_number": "801-357-4992",
            "fax_number": "801-357-7746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043380",
            "telephone_number": "801-357-4992",
            "fax_number": "801-357-7746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "WENDY",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "276738-4408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.