Individual provider Active NPI

Julianne Fallentine, CFNP

  • Family Nurse Practitioner
  • SLC, UT
National Provider Identifier
1356366181
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
219839-4405 Issued in UT
Practice address
855 California Ave
SLC, UT 84104-1632
Phone
(801) 977-0502
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 219839-4405 UT Primary

Addresses

Primary practice location

855 California Ave
SLC, UT 84104-1632

Mailing address

855 California Ave
SLC, UT 84104-1632
Phone (801) 977-0502

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
I20041112000446 UT Practitioner - Nurse Practitioner 2264496033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

2000 S 900
Salt Lake City, UT 84105-3208
Phone (801) 464-7500

Hospital & facility affiliations

  • Intermountain Homecare Home Health Salt Lake Home health agency, South Jordan, UT, CCN 467030
  • Intermountain Health Spanish Fork Hospital Hospital, Spanish Fork, UT, CCN 460062
  • Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
219839-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Aug 11, 2012 Accepting new patients
Ihc Health Services Inc Family Medicine CurrentSince Aug 11, 2012 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

750 W 200 N
Provo, UT 84601
Phone (801) 357-5757

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

2000 S 900 E
Slc, UT 84105
Phone (801) 446-7786

324 Tenth Ave
Ste 178
Slc, UT 84103
Phone (801) 321-2500

855 W California Ave
Slc, UT 84104
Phone (801) 677-0502

819 E Market Place Dr
Spanish Fork, UT 84660
Phone (385) 344-6600

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

3930 W Parkway Blvd
West Valley City, UT 84120
Phone (435) 462-2441

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356366181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 CALIFORNIA AVE",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841041632",
            "telephone_number": "801-977-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 CALIFORNIA AVE",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841041632",
            "telephone_number": "801-977-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLENTINE",
        "first_name": "JULIANNE",
        "name_prefix": "Ms.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "219839-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in SLC, UT

Sources for this page

Verify at the official NPI Registry.