Individual provider Active NPI

Emanita Christable Mounga, FNP-C

  • Family Nurse Practitioner
  • West Valley, UT
National Provider Identifier
1306322441
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9131166-4405 Issued in UT
Practice address
4133 W. Pioneer Parkway
Ste 100
West Valley, UT 84120
Phone
(801) 250-9638
Fax
(801) 250-3204
NPI assigned
Jul 12, 2018
Last updated
Dec 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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 9131166-4405 UT Primary

Addresses

Primary practice location

4133 W. Pioneer Parkway
Ste 100
West Valley, UT 84120

Mailing address

13473 S Fireback Dr
Riverton, UT 84065-4504
Phone (801) 918-9985

Other practice location 1

3665 S 8400 W
Magna, UT 84044-4907
Phone (801) 250-9638

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emounga@exodushealthcare.com Direct ExodusHealth Medical, PC

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
I20180813001034 UT Practitioner - Nurse Practitioner 5698023331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Exodus Healthcare Network PLLCGroup PAC ID 1456265057, 25 clinicians

Practice addresses (Care Compare)

3665 S 8400
Magna, UT 84044-4907

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.4 of 100Reported as group
Quality
93.33
Promoting interoperability
100
Improvement activities
40
Cost
78.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9131166-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Laser Therapy Company, PLLC Past Accepting new patients

Networks

  • UT PPO

Interoperability endpoints

  • Direct secure messaging: emanita.mounga.1@11893.direct.athenahealth.com
  • Direct secure messaging: emounga@pfm.gwaydirect.com

Organizations & group practices 3

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.

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": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1306322441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13473 S FIREBACK DR",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840654504",
            "telephone_number": "801-918-9985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4133 W. PIONEER PARKWAY",
            "address_2": "STE 100",
            "city": "WEST VALLEY",
            "state": "UT",
            "postal_code": "84120",
            "telephone_number": "801-250-9638",
            "fax_number": "801-250-3204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3665 S 8400 W",
            "address_purpose": "LOCATION",
            "city": "Magna",
            "state": "UT",
            "postal_code": "840444907",
            "country_code": "US",
            "telephone_number": "801-250-9638",
            "fax_number": "801-250-3204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUNGA",
        "first_name": "EMANITA",
        "middle_name": "CHRISTABLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "9131166-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emounga@exodushealthcare.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "ExodusHealth Medical, PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "8012509638",
            "address_1": "4133 W. Pioneer Parkway",
            "address_2": "Ste 100",
            "city": "West Valley",
            "state": "UT",
            "country_code": "US",
            "postal_code": "84120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Valley, UT

Sources for this page

Verify at the official NPI Registry.