Individual provider Active NPI

Sheryl Lee Despiegelaere, NP-C

  • Nurse Practitioner
  • Ogden, UT
National Provider Identifier
1487080438
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8546547-4405 Issued in UT
Practice address
3903 Harrison Blvd Ste 100
Ogden, UT 84403-2361
Phone
(801) 387-8900
Fax
(801) 387-8920
NPI assigned
Sep 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8546547-4405 UT Primary
Nurse Practitioner 363L00000X 8546547-4405 TX

Addresses

Primary practice location

3903 Harrison Blvd Ste 100
Ogden, UT 84403-2361

Mailing address

5444 S Green St
Murray, UT 84123-5632
Phone (801) 313-4140

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
I20140206001777 UT Practitioner - Nurse Practitioner 1456580711 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

3903 Medical Dr
Suite 100
Ogden, UT 84403-2316
Phone (801) 387-8900

4401 Harrison Blvd
Ogden, UT 84403-3195

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

  • Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
  • Intermountain Health Layton Hospital Hospital, Layton, UT, CCN 460061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8546547-4405TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jun 23, 2020 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Mountain Medical Physician Specialists PC Vascular Surgery CurrentSince Sep 25, 2013 Accepting new patients
Ihc Health Services Inc Past Accepting new patients
MMPS Murray Past Accepting new patients
Central Utah Radiology, PC Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

3903 Medical Dr
Ste 100
Ogden, UT 84403
Phone (801) 387-8900

5323 S Woodrow St
Ste 101
Salt Lake City, UT 84107
Phone (801) 313-4118

5323 S Woodrow St
Salt Lake City, UT 84107
Phone (801) 261-8346

5334 S Woodrow St
#100
Salt Lake City, UT 84107
Phone (801) 284-1702

5444 S Green St
Salt Lake City, UT 84123
Phone (801) 262-2647

Organizations & group practices 6

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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1487080438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5444 S GREEN ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-313-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 HARRISON BLVD STE 100",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844032361",
            "telephone_number": "801-387-8900",
            "fax_number": "801-387-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESPIEGELAERE",
        "first_name": "SHERYL",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "8546547-4405",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "8546547-4405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.