Individual provider Active NPI

Emily Shanafelt, FNP

  • Nurse Practitioner
  • Roy, UT
National Provider Identifier
1437694080
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7682828-4405 Issued in UT
Practice address
3485 W 5200 S
Roy, UT 84067-9438
Phone
(801) 475-3900
Fax
(801) 475-3901
NPI assigned
Jan 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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 7682828-4405 UT Primary

Addresses

Primary practice location

3485 W 5200 S
Roy, UT 84067-9438

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3900

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
I20170124001792 UT Practitioner - Nurse Practitioner 2961784186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ogden Clinic PCGroup PAC ID 9638078033, 104 clinicians

Practice addresses (Care Compare)

3485 W 5200
Ogden Clinic Grand View
Roy, UT 84067-9438
Phone (801) 475-3900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7682828-4405UTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ogden Clinic PC Family Medicine CurrentSince Jan 2, 2017 Accepting new patients
Ogden Clinic Specialty Services LLC Current Accepting new patients

Locations

5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100

4650 Harrison Blvd
Ogden, UT 84403
Phone (801) 475-3481

3485 W 5200 S
Roy, UT 84067
Phone (801) 475-3900

1491 E Ridgeline Dr
South Ogden, UT 84405
Phone (317) 790-7550

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

Organizations & group practices 2

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 3

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": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1437694080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3900",
            "fax_number": "801-475-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 W 5200 S",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679438",
            "telephone_number": "801-475-3900",
            "fax_number": "801-475-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAFELT",
        "first_name": "EMILY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-05",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "7682828-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roy, UT

Sources for this page

Verify at the official NPI Registry.