Individual provider Active NPI

Corey Dahl, PA-C

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1376891366
Registry record updated Apr 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8554567-1206 Issued in UT
Practice address
1250 E 3900 S Ste 440
Salt Lake City, UT 84124-1349
Phone
(801) 869-4100
Fax
(801) 869-4119
NPI assigned
Aug 22, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X WY
Physician Assistant 363A00000X 8554567-1206 UT Primary

Addresses

Primary practice location

1250 E 3900 S Ste 440
Salt Lake City, UT 84124-1349

Mailing address

926 Shepard Church Dr
Farmington, UT 84025-2837
Phone (801) 510-8140

Other practice location 1

3838 S 700 E Ste 300
Salt Lake City, UT 84106-1496
Phone (801) 261-4988

Other practice location 2

4460 S Highland Dr Ste 220
Millcreek, UT 84124-3550
Phone (504) 438-4259

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
I20130724000380 UT Practitioner - Physician Assistant 6709035041 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Welscare LLCGroup PAC ID 6901253780, 6 clinicians

Practice addresses (Care Compare)

1250 E 3900
Suite 440
Salt Lake City, UT 84124-1349
Phone (801) 869-4100

4460 S Highland Dr
Suite 200
Millcreek, UT 84124-3550
Phone (804) 438-4259

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Vein & Vascular LLC Welscare of Utah CurrentSince Apr 1, 2026 Accepting new patients
Ma Bo Inc CurrentSince May 31, 2023 Accepting new patients
Scott N Bateman, MD Past Accepting new patients

Locations

4460 S Highland Dr
Ste 220
Salt Lake City, UT 84124
Phone (801) 273-6300

4460 S Highland Dr
Ste 200
Salt Lake City, UT 84124
Phone (804) 438-4259

466 E 500 S
Ste 200
Salt Lake Cty, UT 84111
Phone (801) 485-5055

Organizations & group practices 7

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 2

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": "1345593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777161600000",
    "number": "1376891366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 SHEPARD CHURCH DR",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252837",
            "telephone_number": "801-510-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S STE 440",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241349",
            "telephone_number": "801-869-4100",
            "fax_number": "801-869-4119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3838 S 700 E Ste 300",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841061496",
            "country_code": "US",
            "telephone_number": "801-261-4988",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4460 S Highland Dr Ste 220",
            "address_purpose": "LOCATION",
            "city": "Millcreek",
            "state": "UT",
            "postal_code": "841243550",
            "country_code": "US",
            "telephone_number": "504-438-4259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAHL",
        "first_name": "COREY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-22",
        "last_updated": "2026-04-26",
        "certification_date": "2026-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8554567-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.