Individual provider Active NPI

Theresa Furbish

  • Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1679174908
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
316406-4405 Issued in UT
Practice address
5373 S Green St Ste 400
Salt Lake City, UT 84123-4740
Phone
(833) 442-2670
NPI assigned
Nov 3, 2020
Last updated
Oct 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 316406-4405 UT Primary

Addresses

Primary practice location

5373 S Green St Ste 400
Salt Lake City, UT 84123-4740

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

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
I20220218000233 UT Practitioner - Nurse Practitioner 7517351422 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

5373 S Green St
Suite 400
Murray, UT 84123-4740
Phone (801) 442-2615

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. Psychiatry CurrentSince Jan 22, 2024 Accepting new patients
Valley Mental Health Incorporated Psychiatry Current Accepting new patients
Ihc Health Services Inc CurrentSince Jan 22, 2024 Accepting new patients
Valley Behavioral Health Incorporated Psychiatry CurrentSince Nov 12, 2021 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

4460 S Highland Dr
Ste 210
Salt Lake City, UT 84124
Phone (801) 273-6311

5373 S Green St
Ste 400
Salt Lake City, UT 84123
Phone (801) 442-2615

4460 S Highland Dr
Ste 230
Slc, UT 84124
Phone (801) 263-7227

4460 S Highland Dr
Ste 300
Slc, UT 84124
Phone (801) 273-6300

3809 W 6200 S
Taylorsville, UT 84129
Phone (801) 963-4200

Organizations & group practices 5

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": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1679174908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5373 S GREEN ST STE 400",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841234740",
            "telephone_number": "833-442-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FURBISH",
        "first_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "316406-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.