Individual provider Active NPI

Connorie Jeane Murray, PA

  • Physician Assistant
  • Bountiful, UT
National Provider Identifier
1326691569
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11868464-1206 Issued in UT
Practice address
185 S 400 E Ste 100
Bountiful, UT 84010-4862
Phone
(801) 397-6200
NPI assigned
Jul 17, 2019
Last updated
Mar 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9112272 FL
Physician Assistant 363A00000X 11868464-1206 UT Primary

Addresses

Primary practice location

185 S 400 E Ste 100
Bountiful, UT 84010-4862

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3010

Other identifiers 1

IdentifierTypeStateIssuer
1326691569MedicaidUT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CMURRAY57986@DIRECT.MED.UTAH.EDU Direct University of Utah

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
I20210128002873 UT Practitioner - Physician Assistant 3971745480 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9112272FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Services CurrentSince Dec 15, 2023 Accepting new patients
University of Utah Pediatric Services CurrentSince Dec 15, 2023 Accepting new patients
University of Utah Pediatric Services Past Accepting new patients
Prohealth Select, Inc. Physician Assistant PastSince Dec 17, 2020 Accepting new patients

Locations

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: cmurray57986@direct.med.utah.edu

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1326691569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 S 400 E STE 100",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104862",
            "telephone_number": "801-397-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "CONNORIE",
        "middle_name": "JEANE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9112272",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "11868464-1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326691569",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CMURRAY57986@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.