Individual provider Active NPI

Naomi Shea Nielsen, NP-C

  • Nurse Practitioner
  • Provo, UT
National Provider Identifier
1407237217
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5903890-4405 Issued in UT
Practice address
1055 N 300 W Ste 400
Provo, UT 84604-3359
Phone
(801) 592-7971
NPI assigned
Jun 17, 2015
Last updated
Oct 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5903890-4405 UT Primary

Addresses

Primary practice location

1055 N 300 W Ste 400
Provo, UT 84604-3359

Mailing address

1055 N 300 W Ste 400
Provo, UT 84604
Phone (801) 357-7404

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
I20151014002907 UT Practitioner - Nurse Practitioner 1951610922 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5903890-4405UTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jul 15, 2016 Accepting new patients
Utah Neurological Clinic, PC CurrentSince Sep 12, 2015 Accepting new patients
Ihc Health Services Inc CurrentSince Jul 15, 2016 Accepting new patients
Ihc Health Services Inc Nurse Practitioner Current Accepting new patients
Summit Brain and Spine PC CurrentSince Oct 26, 2019 Accepting new patients

Locations

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

3000 N Triumph Blvd
Ste 110
Lehi, UT 84043
Phone (385) 345-3555

3000 N Triumph Blvd
Ste 330
Lehi, UT 84043
Phone (385) 345-3560

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

1055 N 300 W
Ste 400
Provo, UT 84604
Phone (801) 357-7404

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

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1407237217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 300 W STE 400",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-357-7404",
            "fax_number": "801-357-7587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N 300 W STE 400",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043359",
            "telephone_number": "801-592-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "NAOMI",
        "middle_name": "SHEA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "5903890-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.