Individual provider Active NPI

Mary Ellen Shivers, DNP

  • Acute Care Nurse Practitioner
  • Ogden, UT
National Provider Identifier
1427466168
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
325877-4405 Issued in UT
Practice address
4401 Harrison Blvd
Ogden, UT 84403-3195
Phone
(801) 387-7078
NPI assigned
Jul 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 325877-4405 UT Primary

Addresses

Primary practice location

4401 Harrison Blvd
Ogden, UT 84403-3195

Mailing address

4401 Harrison Blvd
Ogden, UT 84403-3195
Phone (801) 387-7078

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
I20190411002354 UT Practitioner - Nurse Practitioner 5698058113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

4401 Harrison Blvd
Ogden, UT 84403-3195

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
325877-4405UTMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Feb 6, 2019 Accepting new patients
Ihc Health Services Inc CurrentSince Feb 6, 2019 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

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

4403 Harrison Blvd
Ste 3430
Ogden, UT 84403
Phone (801) 387-3866

4403 Harrison Blvd
Ste 3630
Ogden, UT 84403
Phone (801) 387-7900

4401 Harrison Blvd
South Ogden, UT 84403
Phone (801) 387-2800

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1427466168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033195",
            "telephone_number": "801-387-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033195",
            "telephone_number": "801-387-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVERS",
        "first_name": "MARY ELLEN",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-25",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "325877-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.