Individual provider Active NPI

Annemarie Rousseau, APRN

  • Family Nurse Practitioner
  • Vernal, UT
National Provider Identifier
1477075315
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9087991-4405 Issued in UT
Practice address
405 N 500 W BLDG 1
Vernal, UT 84078-1907
Phone
(435) 722-5274
Fax
(435) 247-4207
NPI assigned
Jul 12, 2017
Last updated
Jan 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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 9087991-4405 UT Primary

Addresses

Primary practice location

405 N 500 W BLDG 1
Vernal, UT 84078-1907

Mailing address

405 N 500 W BLDG 1
Vernal, UT 84078-1907
Phone (435) 722-5274

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
I20230928001846 UT Practitioner - Nurse Practitioner 6608220355 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Utah School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Utah Medical GroupGroup PAC ID 2961496609, 52 clinicians

Practice addresses (Care Compare)

210 W 300
Roosevelt, UT 84066-2336
Phone (435) 722-4691

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.32 of 100Reported as apm
Quality
71.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Uintah Basin Medical Center CurrentSince Aug 24, 2023 Accepting new patients
Northeastern Utah Medical Group CurrentSince Aug 24, 2023 Accepting new patients
Uintah Basin Medical Center CurrentSince Aug 24, 2023 Accepting new patients
Northeastern Utah Medical Group CurrentSince Aug 24, 2023 Accepting new patients

Locations

50 E 200 S
Duchesne, UT 84021
Phone (435) 738-2426

210 W 300 N
Roosevelt, UT 84066
Phone (435) 722-4691

250 W 300 N
Roosevelt, UT 84066
Phone (435) 722-4691

250 W 300 N
#752
Roosevelt, UT 84066
Phone (435) 722-4691

250 W 300 N
Ste 75
Roosevelt, UT 84066

405 N 500 W
Vernal, UT 84078
Phone (435) 781-2335

405 N 500 W
Bldg 1
Vernal, UT 84078
Phone (435) 722-5274

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1477075315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N 500 W BLDG 1",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840781907",
            "telephone_number": "435-722-5274",
            "fax_number": "435-247-4207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N 500 W BLDG 1",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840781907",
            "telephone_number": "435-722-5274",
            "fax_number": "435-247-4207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSEAU",
        "first_name": "ANNEMARIE",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "9087991-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernal, UT

Sources for this page

Verify at the official NPI Registry.