Individual provider Active NPI

Elizabeth Ann Demille, PA-C

  • Physician Assistant
  • Hurricane, UT
National Provider Identifier
1245501501
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8154350-1206 Issued in UT
Practice address
75 N 2260 W
Hurricane, UT 84737-2034
Phone
(435) 635-6500
Fax
(435) 635-6549
NPI assigned
Jan 18, 2012
Last updated
Nov 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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 8154350-1206 UT Primary

Addresses

Primary practice location

75 N 2260 W
Hurricane, UT 84737-2034

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other names 1

  • Elizabeth Ann Anderson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

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
I20120831000138 UT Practitioner - Physician Assistant 0345497004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

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

75 N 2260
Hurricane, UT 84737-2034
Phone (435) 251-2650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8154350-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Sep 29, 2025 Accepting new patients
Ihc Health Services Inc CurrentSince Sep 29, 2025 Accepting new patients
Valley Obstetrics and Gynecology, PC Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

1301 Bertha Howe Ave
Ste 11
Mesquite, NV 89027
Phone (435) 656-2020

110 W 1325 N
Ste 175
Cedar City, UT 84721
Phone (435) 586-2229

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

75 N 2260 W
Hurricane, UT 84737
Phone (435) 635-6400

515 S 300 E
Ste 205
St George, UT 84770
Phone (435) 674-0999

1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1245501501",
    "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": "75 N 2260 W",
            "city": "HURRICANE",
            "state": "UT",
            "postal_code": "847372034",
            "telephone_number": "435-635-6500",
            "fax_number": "435-635-6549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMILLE",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-18",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8154350-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "ANDERSON",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hurricane, UT

Sources for this page

Verify at the official NPI Registry.