Individual provider Active NPI

Karina Ann Fasig

  • Physician Assistant
  • Layton, UT
National Provider Identifier
1689258501
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1580 W Antelope Dr Ste 200
Layton, UT 84041-1200
Phone
(801) 773-4770
NPI assigned
May 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1580 W Antelope Dr Ste 200
Layton, UT 84041-1200

Mailing address

375 S Chipeta Way
Salt Lake City, UT 84108-1260

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
I20240123002671 UT Practitioner - Physician Assistant 0547612756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jordan Ridge Family Medicine LLCGroup PAC ID 8820091473, 10 clinicians

Practice addresses (Care Compare)

6321 S Redwood Rd
Suite 201
Taylorsville, UT 84123-6972
Phone (702) 480-2550

Hospital & facility affiliations

  • Holy Cross Hospital-Davis Hospital, Layton, UT, CCN 460041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan Ridge Family Medicine LLC CurrentSince Jan 9, 2023 Accepting new patients

Locations

1580 W Antelope Dr
Ste 200
Layton, UT 84041
Phone (801) 508-4327

6321 S Redwood Rd
Ste 201
Taylorsville, UT 84123
Phone (801) 265-2212

Interoperability endpoints

  • Direct secure messaging: kfasig110470@westdirect.optum.com
  • Direct secure messaging: karinafasig@wpfp.allscriptsdirect.net

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 and National Provider Directory roles.

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": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1689258501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 S CHIPETA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 W ANTELOPE DR STE 200",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411200",
            "telephone_number": "801-773-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASIG",
        "first_name": "KARINA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-06",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.