Individual provider Active NPI

Amelia S Maass, FNP

  • Family Nurse Practitioner
  • West Jordan, UT
National Provider Identifier
1366488348
Registry record updated Nov 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
326830-4405 Issued in UT
Practice address
8846 S Redwood Rd Ste E121
West Jordan, UT 84088-9366
Phone
(801) 569-1999
Fax
(801) 569-2001
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2020

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 326830-4405 UT Primary

Addresses

Primary practice location

8846 S Redwood Rd Ste E121
West Jordan, UT 84088-9366

Mailing address

PO Box 198560
Atlanta, GA 30384-8560

Other identifiers 1

IdentifierTypeStateIssuer
1164672770MedicaidUT

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
I20051020000214 UT Practitioner - Nurse Practitioner 1355367244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mountainstar Medical Group-St. Marks Hospital LLCGroup PAC ID 1557443322, 13 clinicians

Practice addresses (Care Compare)

8846 S Redwood Rd
121 Jordan Family Health
West Jordan, UT 84088-9334
Phone (801) 569-1999

Hospital & facility affiliations

  • Lone Peak Hospital Hospital, Draper, UT, CCN 460060
  • St Mark'S Hospital Hospital, Salt Lake City, UT, CCN 460047
  • Holy Cross Hospital-Jordan Valley Hospital, West Jordan, UT, CCN 460051
  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
326830-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountainstar Medical Group-St. Marks Hospital, LLC CurrentSince Jan 1, 2012 Accepting new patients
Jordan Family Health, LLC Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

74 E Kimballs Ln
Ste 300
Draper, UT 84020
Phone (801) 572-0311

8846 S Redwood Rd
Ste E121
West Jordan, UT 84088
Phone (801) 268-4141

8846 S Redwood Rd
Ste E12
West Jordan, UT 84088
Phone (801) 266-2777

Organizations & group practices 2

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 4

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606435200000",
    "number": "1366488348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198560",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8846 S REDWOOD RD STE E121",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889366",
            "telephone_number": "801-569-1999",
            "fax_number": "801-569-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAASS",
        "first_name": "AMELIA",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2020-11-27",
        "certification_date": "2020-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "326830-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164672770",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

Verify at the official NPI Registry.