NPIMap

Individual provider Active NPI

Nicole Marie Fox, PA-C

  • Physician Assistant
  • Monticello, UT
National Provider Identifier
1609357524
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10958766-1206 Issued in UT
Practice address
380 West 100 North
Monticello, UT 84535
Phone
(435) 587-2116
NPI assigned
Aug 28, 2018
Last updated
Aug 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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 10958766-1206 UT Primary

Addresses

Primary practice location

380 West 100 North
Monticello, UT 84535

Mailing address

7131 S Towncrest Dr
Cottonwood Heights, UT 84121-3822
Phone (385) 242-5205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190401002282 UT Practitioner - Physician Assistant 1850632811 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Juan County HospitalGroup PAC ID 4486541851, 19 clinicians

Practice addresses (Care Compare)

380 W 100
Monticello, UT 84535-0308
Phone (435) 587-2116

380 W 100
Suite a
Monticello, UT 84535-7879
Phone (435) 587-5054

5555 Old Airport Rd
Spanish Valley, UT 84532-5105
Phone (435) 587-1234

PO Box
Suite 1054
Monticello, UT 84535

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10958766-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan County Hospital Family Medicine CurrentSince Mar 1, 2019 Accepting new patients
San Juan County Hospital CurrentSince Nov 24, 2025 Accepting new patients
San Juan County Hospital Past Accepting new patients
San Juan County Hospital Family Medicine Past Accepting new patients

Locations

735 S 200 W
Ste 3
Blanding, UT 84511
Phone (435) 678-2254

5555 Old Airport Rd
Moab, UT 84532
Phone (435) 419-9210

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d2bc3d5a-3c39-4553-86b1-b3aa0a5429a7/
  • Direct secure messaging: nicole.fox.1@17164.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1609357524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7131 S TOWNCREST DR",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841213822",
            "telephone_number": "385-242-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 WEST 100 NORTH",
            "city": "MONTICELLO",
            "state": "UT",
            "postal_code": "84535",
            "telephone_number": "435-587-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "10958766-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, UT

Sources for this page

Verify at the official NPI Registry.