Active NPI
Alli Bascom, APRN
- Family Nurse Practitioner
- Provo, UT
National Provider Identifier
1437874401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 8536735-4405
- Practice address
- 3585 N University Ave Ste 250
Provo, UT 84604-6622 - Phone
- (801) 459-7147
- NPI assigned
- Oct 11, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 8536735-4405 | UT | Primary |
Addresses
Primary practice location
3585 N University Ave Ste 250
Provo, UT 84604-6622
Mailing address
355 S 1200 W
Orem, UT 84058-5150
Phone (801) 358-2149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8536735-4405 | UT | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721088000000",
"number": "1437874401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 S 1200 W",
"city": "OREM",
"state": "UT",
"postal_code": "840585150",
"telephone_number": "801-358-2149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3585 N UNIVERSITY AVE STE 250",
"city": "PROVO",
"state": "UT",
"postal_code": "846046622",
"telephone_number": "801-459-7147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASCOM",
"first_name": "ALLI",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-11",
"last_updated": "2024-07-16",
"certification_date": "2024-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "UT",
"license": "8536735-4405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.