Dallin Trout

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

13793889-1206 Issued in UT

Practice address

585 Main St.
Green River, UT 84525

Phone

(435) 564-3434

NPI assigned

Jul 28, 2022

Last updated

Aug 23, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Physician Assistant

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Green River Medical Center IncGroup PAC ID 3870525843, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Green River Medical Center Inc

  dba Two Rivers Community Health

  • Federally Qualified Health Center (FQHC)
  • Green River, UT
  • NPI 1942317722
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1285360651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 S CHAMBERS RD",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801349498",
            "telephone_number": "303-373-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 MAIN ST.",
            "city": "GREEN RIVER",
            "state": "UT",
            "postal_code": "84525",
            "telephone_number": "435-564-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROUT",
        "first_name": "DALLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-28",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "13793889-1206",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brouquelyn Mia Hatfield-Knight, RDH BSDH
• Kim Thyrill McFarlane, MPAS, PA-C
• Tyler J Rundell, PA-C
• Zackery N Taylor, PHARMD/MBA
• Shannon Taylor Thurston, PA-C
• Loye West, PA-C
• Reagan M Whiteleather, RDH

• Medical Physician Assistant in Green River, UT
• Providers in Green River, UT by specialty
• Medical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.