Individual provider Active NPI

Eric Leonard Sorensen, N.P.

  • Family Nurse Practitioner
  • Logan, UT
National Provider Identifier
1497945091
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5662905-4405 Issued in UT
Practice address
412 N 200 E
Logan, UT 84321-4038
Phone
(435) 713-2777
NPI assigned
Jul 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0024167553 VA
Family Nurse Practitioner 363LF0000X ARNP9308320 FL
Family Nurse Practitioner 363LF0000X 5662905-4405 UT Primary

Addresses

Primary practice location

412 N 200 E
Logan, UT 84321-4038

Mailing address

412 N 200 E
Logan, UT 84321-4038

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-0001
Phone (434) 924-2231

Other identifiers 3

IdentifierTypeStateIssuer
002499500MedicaidFL
DQ733ZOtherMEDICARE PTAN
1497945091MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090526000465 VA Practitioner - Nurse Practitioner 1355490269 Reassigns benefits to 1 organization
I20221114001252 UT Practitioner - Nurse Practitioner 1355490269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
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)

412 N 200
Logan, UT 84321-4038
Phone (435) 713-2800

Hospital & facility affiliations

  • Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9308320FLMDFamily Nurse Practitioner
5662905-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Nov 7, 2022 Accepting new patients
University of Virginia Physicians Group CurrentSince Aug 13, 2012 Accepting new patients
Ihc Health Services Inc CurrentSince Nov 7, 2022 Accepting new patients

Locations

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

201 W Layton Pkwy
Layton, UT 84041
Phone (801) 543-6000

412 N 200 E
Logan, UT 84321
Phone (435) 713-2710

1215 Lee St
Fl 1
Charlottesville, VA 22908
Phone (434) 924-9400

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1497945091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 N 200 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843214038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 N 200 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843214038",
            "telephone_number": "435-713-2777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080001",
            "country_code": "US",
            "telephone_number": "434-924-2231",
            "fax_number": "434-924-9295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "ERIC",
        "middle_name": "LEONARD",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024167553",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9308320",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5662905-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002499500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "DQ733Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497945091",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.