Individual provider Active NPI

Elizabeth Huntsman, FNP-C

  • Nurse Practitioner
  • Provo, UT
National Provider Identifier
1356120455
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
330011-4405 Issued in UT
Practice address
320 River Park Dr Ste 255
Provo, UT 84604-6065
Phone
(801) 999-0147
NPI assigned
Sep 27, 2023
Last updated
Feb 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 330011-4405 UT Primary

Addresses

Primary practice location

320 River Park Dr Ste 255
Provo, UT 84604-6065

Mailing address

320 River Park Dr Ste 255
Provo, UT 84604-6065

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
I20240301003767 UT Practitioner - Nurse Practitioner 8022453885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neural EffectsGroup PAC ID 3072927094, 4 clinicians

Practice addresses (Care Compare)

320 River Park Dr
Suite 255
Provo, UT 84604-6065
Phone (801) 616-3675

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
330011-4405UTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neural Effects Nurse Practitioner CurrentSince Jan 16, 2024 Accepting new patients

Locations

1055 N 300 W
Ste 410
Provo, UT 84604
Phone (801) 225-5407

320 River Park Dr
Ste 255
Provo, UT 84604
Phone (385) 203-0246

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.

NPI Registry JSON

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1356120455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 RIVER PARK DR STE 255",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 RIVER PARK DR STE 255",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046065",
            "telephone_number": "801-999-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTSMAN",
        "first_name": "ELIZABETH",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-27",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "330011-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.