Individual provider Active NPI

Colleen D Dame, NP-BC

  • Acute Care Nurse Practitioner
  • St George, UT
National Provider Identifier
1346091311
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2023193677 Issued in UT
Practice address
617 E Riverside Dr Ste 302
St George, UT 84790-8722
Phone
(435) 652-6024
NPI assigned
Mar 28, 2024
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2023193677 UT Primary

Addresses

Primary practice location

617 E Riverside Dr Ste 302
St George, UT 84790-8722

Mailing address

170 W Dolce CV
St George, UT 84770-8752
Phone (707) 291-9440

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
I20240521002490 UT Practitioner - Nurse Practitioner 5890137905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huntsman West Spine LLCGroup PAC ID 0345476560, 7 clinicians

Practice addresses (Care Compare)

617 E Riverside Dr
Suite 302
St George, UT 84790-8722
Phone (435) 652-6024

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023193677UTMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Huntsman West Spine LLC CurrentSince Apr 15, 2024 Accepting new patients

Locations

2891 E Mall Dr
Ste 105
St George, UT 84790

617 E Riverside Dr
Ste 302
St George, UT 84790
Phone (435) 652-6024

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1346091311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 W DOLCE CV",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847708752",
            "telephone_number": "707-291-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 E RIVERSIDE DR STE 302",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847908722",
            "telephone_number": "435-652-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAME",
        "first_name": "COLLEEN",
        "middle_name": "D",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "2023193677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.