Individual provider Active NPI

Danielle Marie Ricks, PA-C

  • Physician Assistant
  • Moab, UT
National Provider Identifier
1639644123
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10992609-1206 Issued in UT
Practice address
2700 S Highway 191 Ste 2
Moab, UT 84532-3443
Phone
(435) 259-4466
NPI assigned
Oct 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 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 10992609-1206 UT Primary

Addresses

Primary practice location

2700 S Highway 191 Ste 2
Moab, UT 84532-3443

Mailing address

2700 S Highway 191 Ste 2
Moab, UT 84532-3443
Phone (435) 259-4466

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
I20220118002143 UT Practitioner - Physician Assistant 8325430606 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Moab Valley Healthcare, Inc. CurrentSince Jul 13, 2024 Accepting new patients
Moab Valley Healthcare, Inc. CurrentSince Jul 13, 2024 Accepting new patients
Moab Valley Healthcare, Inc Past Accepting new patients

Locations

450 W Williams Way
Moab, UT 84532
Phone (435) 259-7191

476 W Williams Way
Moab, UT 84532
Phone (435) 719-3500

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": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1639644123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 S HIGHWAY 191 STE 2",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "845323443",
            "telephone_number": "435-259-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 S HIGHWAY 191 STE 2",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "845323443",
            "telephone_number": "435-259-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKS",
        "first_name": "DANIELLE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "10992609-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moab, UT

Sources for this page

Verify at the official NPI Registry.