Active NPI
Adrienne Shaver, NP
- Nurse Practitioner
- American Fork, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 326445-4405
- 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, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN129295 | AZ | MD | Nurse Practitioner |
| 326445-4405 | UT | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revere Health PC | Current | Accepting new patients | |
| Revere Health PC | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.