Individual provider Active NPI

Adrienne Shaver, NP

  • Nurse Practitioner
  • American Fork, UT
National Provider Identifier
1659595742
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
326445-4405 Issued in UT
Practice address
1175 E 50 S
Suite 221
American Fork, UT 84003-2845
Phone
(801) 772-0775
Fax
(801) 772-1941
NPI assigned
Apr 12, 2007
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN129295 AZ
Nurse Practitioner 363L00000X 326445-4405 UT Primary

Addresses

Primary practice location

1175 E 50 S
Suite 221
American Fork, UT 84003-2845

Mailing address

1055 N 500 W
Attn: Credentialing
Provo, UT 84604-3305
Phone (801) 354-8225

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address medreview@reverehealth.com Revere Health PC

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
I20090303000531 UT Practitioner - Nurse Practitioner 9436215241 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN129295AZMDNurse Practitioner
326445-4405UTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Mar 16, 2015 Accepting new patients
Revere Health PC CurrentSince Mar 16, 2015 Accepting new patients

Locations

1175 E 50 S
Ste 211
American Fork, UT 84003
Phone (801) 418-0807

1175 E 50 S
Ste 221
American Fork, UT 84003
Phone (801) 772-0775

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1659595742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 E 50 S",
            "address_2": "SUITE 221",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032845",
            "telephone_number": "801-772-0775",
            "fax_number": "801-772-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAVER",
        "first_name": "ADRIENNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2023-11-27",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "RN129295",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "326445-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Revere Health PC",
            "address_1": "1175 E 50 S",
            "address_2": "Suite 221",
            "city": "American Fork",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840032845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.