NPIMap

Individual provider Active NPI

Amy Jo Fowers, FNP

  • Family Nurse Practitioner
  • West Haven, UT
National Provider Identifier
1407432933
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8003914-4405 Issued in UT
Practice address
4460 Stone Creek Rd Unit B
West Haven, UT 84401-6924
Phone
(801) 781-0798
NPI assigned
Mar 23, 2021
Last updated
Mar 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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 8003914-4405 UT Primary

Addresses

Primary practice location

4460 Stone Creek Rd Unit B
West Haven, UT 84401-6924

Mailing address

4460 Stone Creek Rd Unit B
West Haven, UT 84401-6924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210421001490 UT Practitioner - Nurse Practitioner 9234547779 Reassigns benefits to 2 organizations
I20250113002881 CA Practitioner - Nurse Practitioner 9234547779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Impact Medical Associates CaliforniaGroup PAC ID 3274902267, 5 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Gary F Holland MD PCGroup PAC ID 2668466350, 9 clinicians

Practice addresses (Care Compare)

Kaysville, UT 84037
Phone (858) 487-8778

11838 Bernardo Plaza CT
Suite 260a
San Diego, CA 92128-2413
Phone (619) 872-5288

2600 Compass Rd
Glenview, IL 60026-8001

375 N Main St
Suite 103
Kaysville, UT 84037-1272
Phone (801) 876-3749

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8003914-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gary F Holland MD PC CurrentSince Mar 29, 2021 Accepting new patients
Owen Healthcare, LLC Past Accepting new patients

Locations

375 N Main St
Ste 103
Kaysville, UT 84037
Phone (801) 216-4130

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1407432933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 STONE CREEK RD UNIT B",
            "city": "WEST HAVEN",
            "state": "UT",
            "postal_code": "844016924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 STONE CREEK RD UNIT B",
            "city": "WEST HAVEN",
            "state": "UT",
            "postal_code": "844016924",
            "telephone_number": "801-781-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWERS",
        "first_name": "AMY",
        "middle_name": "JO",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "8003914-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, UT

Sources for this page

Verify at the official NPI Registry.