Individual provider Active NPI

Bruce A McPherson, PA

  • Physician Assistant
  • St George, UT
National Provider Identifier
1265419451
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2151681206 Issued in UT
Practice address
2825 E Mall Dr
St George, UT 84790-1954
Phone
(435) 628-9393
Fax
(435) 628-9382
NPI assigned
Dec 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA852 NV
Surgical Physician Assistant 363AS0400X PA852 NV
Surgical Physician Assistant 363AS0400X 2151681206 UT
Physician Assistant 363A00000X 2151681206 UT Primary

Addresses

Primary practice location

2825 E Mall Dr
St George, UT 84790-1954

Mailing address

1055 N 500 W
Attn: Credentialing
Provo, UT 84604-3305
Phone (801) 354-8225

Other practice location 1

330 Falcon Ridge Pkwy Ste 4000A
Mesquite, NV 89027-8877
Phone (435) 628-9393

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address medreveiw@reverehealth.com Central Utah Clinic, P.C.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040714001246 UT Practitioner - Physician Assistant 8820077860 Reassigns benefits to 1 organization
I20070112000434 NV Practitioner - Physician Assistant 8820077860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

1055 N 500
Provo, UT 84604-3305

2825 E Mall Dr
St George, UT 84790-1954
Phone (435) 673-6131

330 Falcon Ridge Pkwy
Suite 400a
Mesquite, NV 89027-8881
Phone (435) 628-9393

Hospital & facility affiliations

  • St. George Regional Hospital Hospital, St George, UT, CCN 460021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1722171205UTMDOrthopaedic Surgery Physician
PA852NVMDSurgical Physician Assistant
2151681206UTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Sep 1, 2011 Accepting new patients
Revere Health PC CurrentSince Sep 1, 2011 Accepting new patients
MMC of Nevada LLC Past Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients

Locations

1301 Bertha Howe Ave
Ste 1
Mesquite, NV 89027
Phone (702) 346-0200

330 Falcon Ridge Pkwy
Ste 400A
Mesquite, NV 89027
Phone (435) 251-2900

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

2825 E Mall Dr
St George, UT 84790
Phone (435) 673-6131

1490 E Foremaster Dr
Ste 150
St George, UT 84790
Phone (435) 673-5373

Interoperability endpoints

  • Direct secure messaging: brucemcpherson@cuccu.allscriptsdirect.net

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.

Hospital & facility affiliations 1

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1265419451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 E MALL DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847901954",
            "telephone_number": "435-628-9393",
            "fax_number": "435-628-9382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Falcon Ridge Pkwy Ste 4000A",
            "address_purpose": "LOCATION",
            "city": "Mesquite",
            "state": "NV",
            "postal_code": "890278877",
            "country_code": "US",
            "telephone_number": "435-628-9393",
            "fax_number": "435-628-9382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCPHERSON",
        "first_name": "BRUCE",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA852",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA852",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "UT",
            "license": "2151681206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "2151681206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreveiw@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Central Utah Clinic, P.C.",
            "address_1": "1490 E Foremaster Dr",
            "address_2": "#150",
            "city": "St George",
            "state": "UT",
            "country_code": "US",
            "postal_code": "847904488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.