Active NPI
Candra Bunn, PA
- Physician Assistant
- Riverton, UT
National Provider Identifier
1477301679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 14246993-1206
- Practice address
- 3773 W 12600 S
Riverton, UT 84065-5577 - Phone
- (801) 285-1285
- NPI assigned
- May 11, 2024
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 14246993-1206 | UT | Primary |
Addresses
Primary practice location
3773 W 12600 S
Riverton, UT 84065-5577
Mailing address
PO Box 30180
Salt Lake City, UT 84130-0180
Other practice location 1
1800 Novell Pl
Provo, UT 84606-6171
Phone (801) 907-1342
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC/ Office Ally |
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14246993-1206 | UT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763942400000",
"number": "1477301679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30180",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841300180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3773 W 12600 S",
"city": "RIVERTON",
"state": "UT",
"postal_code": "840655577",
"telephone_number": "801-285-1285"
}
],
"practiceLocations": [
{
"address_1": "1800 Novell Pl",
"address_purpose": "LOCATION",
"city": "Provo",
"state": "UT",
"postal_code": "846066171",
"country_code": "US",
"telephone_number": "801-907-1342",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUNN",
"first_name": "CANDRA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-11",
"last_updated": "2025-11-24",
"certification_date": "2025-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "14246993-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC/ Office Ally",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Riverton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.