Individual provider Active NPI

Cynthia Zumbrennen, PA

  • Physician Assistant
  • Bountiful, UT
National Provider Identifier
1255362323
Registry record updated Jun 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4761453-1206 Issued in UT
Practice address
390 N Main St
Bountiful, UT 84010-6046
Phone
(801) 294-1020
Fax
(801) 292-8369
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2009

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 4761453-1206 UT Primary

Addresses

Primary practice location

390 N Main St
Bountiful, UT 84010-6046

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 294-1020

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
I20080815000578 UT Practitioner - Physician Assistant 1254406853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
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)

390 N Main St
Bountiful, UT 84010-6046
Phone (801) 776-4444

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4761453-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jan 1, 2001 Accepting new patients
Ihc Health Services Inc CurrentSince Jan 1, 2001 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

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

390 N Main St
N Salt Lake, UT 84010
Phone (801) 294-1000

Organizations & group practices 4

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245974400000",
    "number": "1255362323",
    "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",
            "telephone_number": "801-294-1020",
            "fax_number": "801-292-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N MAIN ST",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106046",
            "telephone_number": "801-294-1020",
            "fax_number": "801-292-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUMBRENNEN",
        "first_name": "CYNTHIA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2009-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "4761453-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.