Active NPI
Justin Brian Poole, PA
- Physician Assistant
- St George, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 2825 E Mall Dr
St George, UT 84790-1954 - Phone
- (435) 215-0400
- Fax
- (435) 215-0451
- NPI assigned
- May 16, 2017
- Last updated
- Oct 14, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | 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
350 Falcon Ridge Pkwy Ste 500
Mesquite, NV 89027-8878
Phone (725) 333-9026
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | medreview@reverehealth.com | Central Utah Clinic, P.C. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
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
350 Falcon Ridge Pkwy
Suite 500
Mesquite, NV 89027-8878
Phone (725) 333-9026
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revere Health PC | Current | Accepting new patients | |
| Revere Health PC | Current | Accepting new patients |
Locations
330 Falcon Ridge Pkwy
Ste 400A
Mesquite, NV 89027
Phone (435) 251-2900
350 Falcon Ridge Pkwy
Ste 500
Mesquite, NV 89027
Phone (725) 333-9026
1870 N Main St
Ste 201
Cedar City, UT 84721
Phone (435) 383-9009
1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000
1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362
1380 E Medical Center Dr
Ste 4100
St George, UT 84790
Phone (435) 251-2900
2825 E Mall Dr
St George, UT 84790
Phone (435) 673-6131
Interoperability endpoints
- justinpoole@cuccu.allscriptsdirect.net
Organizations & group practices 2
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 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Intermountain Health St. George Regional Hospital
- General Acute Care Hospital
- St George, UT
- NPI 1366452880
-
dba Mesa View Regional Hospital
- Critical Access Hospital
- Mesquite, NV
- NPI 1275588782
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728864000000",
"number": "1306373881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 N 500 W 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": "435-215-0400",
"fax_number": "435-215-0451"
}
],
"practiceLocations": [
{
"address_1": "350 Falcon Ridge Pkwy Ste 500",
"address_purpose": "LOCATION",
"city": "Mesquite",
"state": "NV",
"postal_code": "890278878",
"country_code": "US",
"telephone_number": "725-333-9026",
"fax_number": "725-333-9027",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POOLE",
"first_name": "JUSTIN",
"middle_name": "BRIAN",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-16",
"last_updated": "2024-10-14",
"certification_date": "2024-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "medreview@reverehealth.com",
"affiliation": "Y",
"affiliationName": "Central Utah Clinic, P.C.",
"address_1": "2825 E Mall Dr",
"city": "St George",
"state": "UT",
"country_code": "US",
"postal_code": "847901954",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.