Individual provider Active NPI

Ann Marie Ahee, DNP, APRN, NP-C

  • Nurse Practitioner
  • St George, UT
National Provider Identifier
1417575564
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5359143-4405 Issued in UT
Practice address
2825 E Mall Dr
St George, UT 84790-1954
Phone
(801) 354-8225
Fax
(018) 418-0941
NPI assigned
Jul 6, 2020
Last updated
Nov 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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 5359143-4405 UT Primary

Addresses

Primary practice location

2825 E Mall Dr
St George, UT 84790-1954

Mailing address

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

Other practice location 1

1500 E Split Rock Dr Unit 70
Ivins, UT 84738-6564
Phone (435) 229-0725

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@reverehealth.com Direct Revere Health PC

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
I20200810003512 UT Practitioner - Nurse Practitioner 7810080876 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5359143-4405UTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Sep 1, 2020 Accepting new patients
Corner Clinic St George LLC CurrentSince Dec 1, 2022 Accepting new patients
Dixie Palliative Care, LLC CurrentSince Aug 1, 2021 Accepting new patients
Revere Health PC CurrentSince Sep 1, 2020 Accepting new patients
Night Light Pediatrics LLC Past Accepting new patients
Jerry D Twiggs MD PC Past Accepting new patients
Jason a Ahee MD PC PastSince Dec 15, 2003 Accepting new patients

Locations

380 E Main St
Fl 2ND
Midway, UT 84049

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

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

1930 W Sunset Blvd
Ste 94
St George, UT 84770
Phone (435) 375-0140

2351 S River Rd
Ste 5
St George, UT 84790
Phone (435) 659-7352

2825 E Mall Dr
St George, UT 84790
Phone (435) 673-6131

352 E Riverside Dr
Ste B3B
St George, UT 84790
Phone (435) 628-8347

736 S 900 E
Ste 203
St George, UT 84790
Phone (435) 673-6131

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, 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": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1417575564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W, ATTN. CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "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": "2825 E MALL DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847901954",
            "telephone_number": "801-354-8225",
            "fax_number": "018-418-0941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Split Rock Dr Unit 70",
            "address_purpose": "LOCATION",
            "city": "Ivins",
            "state": "UT",
            "postal_code": "847386564",
            "country_code": "US",
            "telephone_number": "435-229-0725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHEE",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "DNP,  APRN,  NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "5359143-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Revere Health PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1055 N 500 W",
            "city": "Provo",
            "state": "UT",
            "country_code": "US",
            "postal_code": "846043305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.