Individual provider Active NPI

Steven Ivan White, PA

  • Physician Assistant
  • Bountiful, UT
National Provider Identifier
1487935045
Registry record updated Dec 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8071288-1206 Issued in UT
Practice address
458 N 500 W
Bountiful, UT 84010-6948
Phone
(801) 292-9355
NPI assigned
Sep 8, 2011
Last updated
Dec 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8071288-1206 UT Primary

Addresses

Primary practice location

458 N 500 W
Bountiful, UT 84010-6948

Mailing address

8592 S Wasatch Blvd
Salt Lake City, UT 84121-6044
Phone (801) 510-1983

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
I20160210002191 UT Practitioner - Physician Assistant 9234433343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2000 Health Park Dr
Brentwood, TN 37027-4692

PO Box
Suite 307
Bountiful, UT 84011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8071288-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Firstmed East LLC CurrentSince May 1, 2018 Accepting new patients
Firstmed LLC CurrentSince May 1, 2018 Accepting new patients
Integrated Functional Medicine, LLC CurrentSince Dec 22, 2015 Accepting new patients
Integrated Functional Medicine Current Accepting new patients
Firstmed Central LLC CurrentSince May 1, 2018 Accepting new patients
Firstmed Murray CurrentSince May 1, 2018 Accepting new patients
Firstmed North LLC CurrentSince May 1, 2018 Accepting new patients
Utah Imaging Associates Inc Past Accepting new patients

Locations

1512 Renaissance Towne Dr
Bountiful, UT 84010
Phone (801) 295-6483

458 N 500 W
Bountiful, UT 84010
Phone (801) 292-9355

5911 S Fashion Blvd
Salt Lake City, UT 84107
Phone (801) 266-6483

1950 E Fort Union Blvd
Salt Lake Cty, UT 84121
Phone (801) 943-1041

441 S Redwood Rd
Slc, UT 84104
Phone (801) 973-2588

8822 S Redwood Rd
West Jordan, UT 84088
Phone (801) 256-0009

Organizations & group practices 8

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450224000000",
    "number": "1487935045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8592 S WASATCH BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216044",
            "telephone_number": "801-510-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 N 500 W",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106948",
            "telephone_number": "801-292-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "STEVEN",
        "middle_name": "IVAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-08",
        "last_updated": "2015-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8071288-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.