Individual provider Active NPI

Autum Christensen, APRN

  • Family Nurse Practitioner
  • St George, UT
National Provider Identifier
1669619466
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5057450-4405 Issued in UT
Practice address
1490 E Foremaster Dr
Ste 200
St George, UT 84790-4488
Phone
(435) 628-1641
Fax
(435) 628-1660
NPI assigned
Jan 15, 2009
Last updated
Jul 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5057450-4405 UT Primary

Addresses

Primary practice location

1490 E Foremaster Dr
Ste 200
St George, UT 84790-4488

Mailing address

1490 E Foremaster Dr
Ste 200
St George, UT 84790-4488
Phone (435) 628-1641

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
I20090409000100 UT Practitioner - Nurse Practitioner 6305993338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Surgical Associates IncGroup PAC ID 4486686698, 48 clinicians

Practice addresses (Care Compare)

3550 N Univ Ave
Provo, UT 84604-6685
Phone (801) 374-9625

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5057450-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Surgical Associates, Inc. CurrentSince Aug 1, 2013 Accepting new patients
Utah Surgical Associates Surgery Past Accepting new patients
Utah Weight Loss, LLC Past Accepting new patients

Locations

3550 N University Ave
Ste 250
Provo, UT 84604
Phone (801) 374-9625

1490 E Foremaster Dr
Ste 200
St George, UT 84790
Phone (435) 528-1641

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1669619466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 E FOREMASTER DR",
            "address_2": "STE 200",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904488",
            "telephone_number": "435-628-1641",
            "fax_number": "435-628-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 E FOREMASTER DR",
            "address_2": "STE 200",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904488",
            "telephone_number": "435-628-1641",
            "fax_number": "435-628-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "AUTUM",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-15",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5057450-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.