Active NPI
Amy Pearl Mortenson, SSW
- Case Manager/Care Coordinator
- St George, UT
National Provider Identifier
1649312943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 5198080-3503
- Practice address
- 474 W 200 N
Suite 100
St George, UT 84770-4505 - Phone
- (435) 634-5600
- Fax
- (435) 986-8700
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 5198080-3503 | UT | Primary |
Addresses
Primary practice location
474 W 200 N
Suite 100
St George, UT 84770-4505
Mailing address
474 W 200 N
Suite 300
St George, UT 84770-4505
Phone (435) 634-5600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5198080-3503 | Other | UT | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5198080-3503 | UT | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649312943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "474 W 200 N",
"address_2": "SUITE 300",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847704505",
"telephone_number": "435-634-5600",
"fax_number": "435-986-8700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "474 W 200 N",
"address_2": "SUITE 100",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847704505",
"telephone_number": "435-634-5600",
"fax_number": "435-986-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTENSON",
"first_name": "AMY",
"middle_name": "PEARL",
"credential": "SSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "UT",
"license": "5198080-3503",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "5198080-3503",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.