Individual provider Active NPI

Trevor Scott Butler, PA-C

  • Physician Assistant
  • Provo, UT
National Provider Identifier
1629516166
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10217377-1206 Issued in UT
Practice address
395 W Cougar Blvd Ste 101
Provo, UT 84604-3334
Phone
(801) 357-8156
NPI assigned
Feb 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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 10217377-1206 UT Primary

Addresses

Primary practice location

395 W Cougar Blvd Ste 101
Provo, UT 84604-3334

Mailing address

5848 S Fashion Blvd Ste 110
Salt Lake City, UT 84107-6175
Phone (801) 314-4188

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
I20170330000822 UT Practitioner - Physician Assistant 2769767904 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

1034 N 500
Provo, UT 84604-3380

170 N 1100
American Fork, UT 84003-2096

395 W Bulldog Blvd
Provo, UT 84604-3311

395 W Bulldog Blvd
Provo, UT 84604-3334

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

98 N 1100
American Fork, UT 84003-2947

Hospital & facility affiliations

  • Intermountain Homecare Home Health Salt Lake Home health agency, South Jordan, UT, CCN 467030
  • Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001
  • American Fork Hospital Hospital, American Fork, UT, CCN 460023

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jun 3, 2017 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jun 3, 2017 Accepting new patients
Ihc Health Services Inc CurrentSince Jun 1, 2019 Accepting new patients

Locations

98 N 1100 E
Ste 302
American Fork, UT 84003
Phone (801) 357-7081

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

395 W Cougar Blvd
Ste 101
Provo, UT 84604
Phone (801) 357-8156

5171 S Cottonwood St
Ste 305
Salt Lake City, UT 84107
Phone (801) 507-9310

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

5848 S Fashion Blvd
Ste 110
Salt Lake Cty, UT 84107
Phone (801) 314-4188

354 W State Road 73
Saratoga Springs, UT 84045
Phone (801) 341-5200

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1486166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1629516166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5848 S FASHION BLVD STE 110",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841076175",
            "telephone_number": "801-314-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W COUGAR BLVD STE 101",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043334",
            "telephone_number": "801-357-8156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "TREVOR",
        "middle_name": "SCOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-04",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "10217377-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.