Individual provider Active NPI

Angela Weil, FNP-C

  • Family Nurse Practitioner
  • Ogden, UT
National Provider Identifier
1619426376
Registry record updated Jan 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5150906-4405 Issued in UT
Practice address
2540 Washington Blvd Ste 122
Ogden, UT 84401-3112
Phone
(801) 395-6499
Fax
(801) 334-9804
NPI assigned
Sep 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5150906-4405 UT Primary

Addresses

Primary practice location

2540 Washington Blvd Ste 122
Ogden, UT 84401-3112

Mailing address

2540 Washington Blvd Ste 122
Ogden, UT 84401-3112
Phone (801) 395-6499

Other names 1

  • Angela Peterson Former name

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
I20161107000727 UT Practitioner - Nurse Practitioner 9335427707 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5150906-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Clinics of Utah CurrentSince Jan 3, 2017 Accepting new patients
Health Clinics of Utah Current Accepting new patients
State of Utah CurrentSince Jan 3, 2017 Accepting new patients

Locations

2540 Washington Blvd
Ste 122
Ogden, UT 84401
Phone (801) 626-3670

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485561600000",
    "number": "1619426376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 WASHINGTON BLVD STE 122",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844013112",
            "telephone_number": "801-395-6499",
            "fax_number": "801-334-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 WASHINGTON BLVD STE 122",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844013112",
            "telephone_number": "801-395-6499",
            "fax_number": "801-334-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIL",
        "first_name": "ANGELA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-22",
        "last_updated": "2017-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5150906-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "PETERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.