Individual provider Active NPI

Paula S Wolf, FNP-C

  • Family Nurse Practitioner
  • West Valley City, UT
National Provider Identifier
1407445950
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5175852-4408 Issued in UT
Practice address
3336 S Pioneer Pkwy
West Valley City, UT 84120-2000
Phone
(801) 964-8726
NPI assigned
Jan 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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 5175852-4408 UT Primary

Addresses

Primary practice location

3336 S Pioneer Pkwy
West Valley City, UT 84120-2000

Mailing address

3336 S Pioneer Pkwy
West Valley City, UT 84120-2000
Phone (801) 964-8726

Other identifiers 1

IdentifierTypeStateIssuer
U000111043MedicaidUT

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
I20210623001605 UT Practitioner - Nurse Practitioner 6800297235 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5175852-4408UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Valley Family and Preventive Family Medicine CurrentSince Dec 5, 2022 Accepting new patients
Hunter Medical Center, Inc Family Medicine CurrentSince Jun 3, 2021 Accepting new patients
Hunter Medical Center, Inc Family Medicine PastSince Jan 1, 2021 Accepting new patients

Locations

3354 W 7800 S
West Jordan, UT 84088
Phone (801) 282-2677

3534 S 6000 W
West Valley City, UT 84128
Phone (801) 658-6904

3336 S Pioneer Pkwy
Ste 302
West Valley City, UT 84120
Phone (801) 964-8726

Interoperability endpoints

  • Direct secure messaging: ms_pwolf11@landmarkhealth-direct.org

Organizations & group practices 3

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": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1407445950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3336 S PIONEER PKWY",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841202000",
            "telephone_number": "801-964-8726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3336 S PIONEER PKWY",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841202000",
            "telephone_number": "801-964-8726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "PAULA",
        "middle_name": "S",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5175852-4408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "U000111043",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

Verify at the official NPI Registry.