Individual provider Active NPI

John Alan Grotegut, APRN

  • Family Nurse Practitioner
  • Provo, UT
National Provider Identifier
1568042588
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5258354-4405 Issued in UT
Practice address
1300 E Center St
Provo, UT 84606-3554
Phone
(801) 344-4400
NPI assigned
Apr 13, 2021
Last updated
Jul 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 907295 MS
Family Nurse Practitioner 363LF0000X ARNP.AP.70128561-NP WA
Family Nurse Practitioner 363LF0000X 5258354-4405 UT Primary

Addresses

Primary practice location

1300 E Center St
Provo, UT 84606-3554

Mailing address

1383 S 2600 E
Spanish Fork, UT 84660-9392
Phone (801) 361-8062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID, MS3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20210512001809 UT Practitioner - Nurse Practitioner 1355750977 Reassigns benefits to 1 organization
I20221010002264 ID Practitioner - Nurse Practitioner 1355750977 Reassigns benefits to 1 organization
I20250317000929 MS Practitioner - Nurse Practitioner 1355750977 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5258354-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Care Connections, LLC. CurrentSince Sep 26, 2022 Accepting new patients
Molina Healthcare of Utah Inc Family CurrentSince May 3, 2021 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689

188 E Capitol St
Ste 700
Jackson, MS 39201
Phone (844) 809-8438

7050 S Union Park Ave
Ste 200
Midvale, UT 84047
Phone (562) 549-3966

Interoperability endpoints

  • FHIR API: https://epicproxy.et1057.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: jgrotegut12442@direct-prd.molinahealthcare.com

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, 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": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1568042588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1383 S 2600 E",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846609392",
            "telephone_number": "801-361-8062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E CENTER ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846063554",
            "telephone_number": "801-344-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTEGUT",
        "first_name": "JOHN",
        "middle_name": "ALAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-13",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "907295",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "ARNP.AP.70128561-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5258354-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.