Individual provider Active NPI

Michael Rasmussen

  • Nurse Practitioner
  • Garland, UT
National Provider Identifier
1487056339
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
729798-4405 Issued in UT
Practice address
300 W 1400 S
Garland, UT 84312-9100
Phone
(435) 257-3684
Fax
(435) 257-7554
NPI assigned
Sep 23, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 729798-4405 UT Primary

Addresses

Primary practice location

300 W 1400 S
Garland, UT 84312-9100

Mailing address

300 W 1400 S
Garland, UT 84312-9100
Phone (801) 360-3662

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
I20200612001938 UT Practitioner - Nurse Practitioner 8426470899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Uniformed Services Uhs Fe Hebert School of Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Douglas C. Walker D.O., P.C.Group PAC ID 8729991070, 2 clinicians

Practice addresses (Care Compare)

300 W 1400
Garland, UT 84312-9100
Phone (435) 257-3684

Hospital & facility affiliations

  • Nell J Redfield Memorial Hospital Hospital, Malad City, ID, CCN 131303
  • Bear River Valley Hospital Hospital, Tremonton, UT, CCN 460039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
729798-4405UTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas C. Walker D.O., P.C. Single Specialty CurrentSince May 15, 2020 Accepting new patients
Bear River Medical Arts PC Single Specialty CurrentSince May 15, 2020 Accepting new patients

Locations

300 W 1400 S
Garland, UT 84312
Phone (435) 257-2469

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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 2

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": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1487056339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W 1400 S",
            "city": "GARLAND",
            "state": "UT",
            "postal_code": "843129100",
            "telephone_number": "801-360-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W 1400 S",
            "city": "GARLAND",
            "state": "UT",
            "postal_code": "843129100",
            "telephone_number": "435-257-3684",
            "fax_number": "435-257-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASMUSSEN",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "729798-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, UT

Sources for this page

Verify at the official NPI Registry.