Individual provider Active NPI

Maria DJ Villagrana, APRN

  • Family Nurse Practitioner
  • Provo, UT
National Provider Identifier
1295347169
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7970034-4405 Issued in UT
Practice address
589 S State St
Provo, UT 84606-5056
Phone
(801) 429-2000
NPI assigned
Aug 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7970034-4405 UT Primary

Addresses

Primary practice location

589 S State St
Provo, UT 84606-5056

Mailing address

589 S State St
Provo, UT 84606-5056

Other names 1

  • Mary Villagrana Professional name

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
I20201023001457 UT Practitioner - Nurse Practitioner 1355761719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Personal Choice Medical Center IncGroup PAC ID 6406336841, 4 clinicians

Practice addresses (Care Compare)

1175 E 3200
Lehi, UT 84043-5464
Phone (801) 407-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7970034-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Choice Medical Center Inc CurrentSince Dec 22, 2025 Accepting new patients

Locations

1175 E 3200 N
Ste 1
Lehi, UT 84043

1175 E 3200 N
Lehi, UT 84043
Phone (801) 407-3000

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": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1295347169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "589 S STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "589 S STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065056",
            "telephone_number": "801-429-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAGRANA",
        "first_name": "MARIA",
        "middle_name": "DJ",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "7970034-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "VILLAGRANA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.