Individual provider Active NPI

Danielle M Demeter, CNM

  • Family Nurse Practitioner
  • Park City, UT
National Provider Identifier
1265447940
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5167458-4405 Issued in UT
Practice address
1526 Ute Blvd Ste 212
Park City, UT 84098-7654
Phone
(435) 615-8500
Fax
(435) 214-7246
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 5167458-4402 UT
Family Nurse Practitioner 363LF0000X 5167458-4405 UT Primary

Addresses

Primary practice location

1526 Ute Blvd Ste 212
Park City, UT 84098-7654

Mailing address

1139 Station Loop Rd
Park City, UT 84098-5425
Phone (435) 640-6848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
5167458-4402UTMDMidwife
5167458-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Park City Dental Spa CurrentSince Sep 10, 2023 Accepting new patients

Locations

1526 Ute Blvd
Ste 212
Park City, UT 84098
Phone (435) 615-8500

Organizations & group practices 1

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1265447940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 STATION LOOP RD",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985425",
            "telephone_number": "435-640-6848",
            "fax_number": "435-214-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 UTE BLVD STE 212",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840987654",
            "telephone_number": "435-615-8500",
            "fax_number": "435-214-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETER",
        "first_name": "DANIELLE",
        "middle_name": "M",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "UT",
            "license": "5167458-4402",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5167458-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.