Mary Deanne Monson, NURSE PRACTIONER
Individual provider Active NPI Family Nurse Practitioner · Bluffdale, UT
NPI 1346097367 · NPPES record last updated May 6, 2024
Key facts
- NPI
- 1346097367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 9260069-4405 (UT)
- Practice address
- 14308 S Classic CV
Bluffdale, UT 84065-5440 - Phone
- (801) 592-5667
- NPI assigned
- May 6, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Valley-Wide Health Systems, Inc.
Practice addresses (Care Compare)
1012 Belmont Ave
La Junta, CO 81050-2101
Phone (719) 383-5900
925 2ND Ave
Monte Vista, CO 81144-1432
Phone (719) 587-1001
Hospital & facility affiliations
- San Luis Valley Regional Medical Center
- Rio Grande Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in UT, CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241107002651 | UT | Practitioner - Nurse Practitioner | 6507390911 | |
| I20250611000854 | CO | Practitioner - Nurse Practitioner | 6507390911 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9260069-4405 | UT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley-Wide Health Systems, Inc | Current |
Accepting new patients | |
| Valley-Wide Health Systems, Inc. | Current |
Accepting new patients | |
| Valley-Wide Health Systems, Inc. | Past | Accepting new patients |
Locations
128 Market St
Alamosa, CO 81101
Phone (719) 587-1001
1131 Main St
Alamosa, CO 81101
Phone (719) 589-2562
1012 Belmont Ave
La Junta, CO 81050
Phone (719) 383-5500
925 2nd Ave
Monte Vista, CO 81144
Phone (719) 587-1001
Interoperability endpoints
- mary.monson.p1@direct.vwhs.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 9260069-4405 | UT | Yes |
Addresses
Primary practice location
14308 S Classic CV
Bluffdale, UT 84065-5440
Mailing address
14308 S Classic CV
Bluffdale, UT 84065-5440
Phone (801) 592-5667
Other names
- Mary Deanne Moak
Other providers in Bluffdale, UT
- Misty Maddera
- Leeann Madrid
- Matthew Marciano
- Liberty Mathews
- Mekenzey Taylor Miles
- Connor Benjamin Morris
- August Marie Moulton
- Elizabeth Muije
- Amber Rochelle Neece
- Needle Corporation
All providers in Bluffdale, UT · Family Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.