Individual provider Active NPI

Rachelle Stone, PA-C

  • Physician Assistant
  • Spanish Fork, UT
National Provider Identifier
1396418091
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12438181-1206 Issued in UT
Practice address
972 N 600 E
Spanish Fork, UT 84660-1306
Phone
(801) 354-8225
Fax
(801) 418-0941
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12438181-1206 UT Primary

Addresses

Primary practice location

972 N 600 E
Spanish Fork, UT 84660-1306

Mailing address

1055 N. 500 W.
Attn Credentialing
Provo, UT 84604-3305
Phone (801) 354-8225

Other practice location 1

325 W Center St
Spanish Fork, UT 84660-2060
Phone (801) 894-1333

Other practice location 2

1016 S Sandbar Way
Spanish Fork, UT 84660-5598
Phone (479) 957-8423

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address medreview@reverehealth.com Direct Central Utah Clinic, P.C.

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
I20211020001211 UT Practitioner - Physician Assistant 0547658726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

972 N 600
Spanish Fork, UT 84660-1306
Phone (801) 374-1268

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince May 2, 2022 Accepting new patients
Revere Health PC CurrentSince May 2, 2022 Accepting new patients

Locations

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

972 N 600 E
Spanish Fork, UT 84660
Phone (385) 265-6060

Interoperability endpoints

  • Direct secure messaging: rachellestone@cuccu.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1396418091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N. 500 W.",
            "address_2": "ATTN CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "972 N 600 E",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601306",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 W Center St",
            "address_purpose": "LOCATION",
            "city": "Spanish Fork",
            "state": "UT",
            "postal_code": "846602060",
            "country_code": "US",
            "telephone_number": "801-894-1333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1016 S Sandbar Way",
            "address_purpose": "LOCATION",
            "city": "Spanish Fork",
            "state": "UT",
            "postal_code": "846605598",
            "country_code": "US",
            "telephone_number": "479-957-8423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STONE",
        "first_name": "RACHELLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12438181-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Central Utah Clinic, P.C.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "972 N 600 E",
            "city": "Spanish Fork",
            "state": "UT",
            "country_code": "US",
            "postal_code": "846601306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spanish Fork, UT

Sources for this page

Verify at the official NPI Registry.