Megan Ellice Crookston

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9551758-1206 Issued in UT

Practice address

3556 W 9800 S Ste 101
South Jordan, UT 84095-3221

Phone

(801) 567-9780

Fax

(801) 567-9826

NPI assigned

Sep 25, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Copperview Medical Center, LLCGroup PAC ID 4284538976, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058
• Lone Peak Hospital Hospital, Draper, UT, CCN 460060

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Copperview Medical Center, LLC

  • Family Medicine Physician
  • South Jordan, UT
  • NPI 1316970924
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services Inc

  • General Acute Care Hospital
  • Riverton, UT
  • NPI 1154551919
  Care Compare affiliation
• Lone Peak Hospital, Inc.

  • General Acute Care Hospital
  • Draper, UT
  • NPI 1770821571
  Care Compare affiliation

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1659773216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3556 W 9800 S STE 101",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840953221",
            "telephone_number": "801-567-9780",
            "fax_number": "801-567-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3556 W 9800 S STE 101",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840953221",
            "telephone_number": "801-567-9780",
            "fax_number": "801-567-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOKSTON",
        "first_name": "MEGAN",
        "middle_name": "ELLICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-25",
        "last_updated": "2022-04-29",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "9551758-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Create Health LLC
• Creek Capital Daybreak LLC
• Crescent Health Clinic
• Austin Taylor Crocker, PA-C
• Nicole Crockett, RPH
• Reiken Crosby
• Kody R Crowell
• Katia Crowther
• Kyle Crutcher, PHARMD
• Ctr Supports

• Physician Assistant in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.