Maurice Manfred Fiedel, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

6210942-4405 Issued in UT

Practice address

2639 W 13220 S
Riverton, UT 84065-2279

Phone

(801) 815-2068

NPI assigned

Nov 20, 2020

Last updated

Sep 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Numinus Wellness Ut IncGroup PAC ID 2163750688, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maurice.fiedel.1@17324.direct.athenahealth.com

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.

• Numinus Wellness Ut Inc

  • Psychiatry Physician
  • Springville, UT
  • NPI 1265092282
  Medicare reassignment Care Compare group NPD
• Grand Valley Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Riverton, UT
  • NPI 1821814930
  NPD Authorized official
• Ogden Internal Medicine & Urology LLC

  • Internal Medicine Physician
  • Ogden, UT
  • NPI 1003001553
  NPD (past)

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1265035257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2639 W 13220 S",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840652279",
            "telephone_number": "801-815-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 W 13220 S",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840652279",
            "telephone_number": "801-815-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIEDEL",
        "first_name": "MAURICE",
        "middle_name": "MANFRED",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "6210942-4405",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "UT",
            "license": "6210942-3102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cicely Fabiano, DPT
• Families First Orthodontics
• Families First Pediatric Dentistry
• Families First Pediatrics
• Brittany Nicole Favero
• Susan Field, CMHC
• First Health Choice
• Ieshia Miriah Fisher
• Joshua Daniel Fitzgerald, PHARMD
• Kimberly Fjelstrom, DPT

• Psychiatric/Mental Health Nurse Practitioner in Riverton, UT
• Providers in Riverton, UT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.