Active NPI
Timothy A Dennis, PA-C
- Physician Assistant
- Panguitch, UT
National Provider Identifier
1376541102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 104445-1206
- Practice address
- 224 N. 400 East
Panguitch, UT 84759 - Phone
- (435) 676-8842
- Fax
- (435) 676-2679
- NPI assigned
- Jul 14, 2005
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 104445-1206 | UT | Primary |
Addresses
Primary practice location
224 N. 400 East
Panguitch, UT 84759
Mailing address
PO Box 1096
Panguitch, UT 84759
Phone (435) 676-8758
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376541102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1096",
"city": "PANGUITCH",
"state": "UT",
"postal_code": "84759",
"telephone_number": "435-676-8758",
"fax_number": "435-676-2679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 N. 400 EAST",
"city": "PANGUITCH",
"state": "UT",
"postal_code": "84759",
"telephone_number": "435-676-8842",
"fax_number": "435-676-2679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNIS",
"first_name": "TIMOTHY",
"middle_name": "A",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "104445-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Panguitch, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.