Individual provider Active NPI

Connie Mitchell Vail, MD

  • Diagnostic Radiology Physician
  • Nephi, UT
National Provider Identifier
1689675076
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
17441-1205 Issued in UT
Practice address
48 W 1500 N
Nephi, UT 84648-8900
Phone
(435) 623-3000
NPI assigned
Aug 9, 2005
Last updated
Dec 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 17441-1205 UT Primary

Addresses

Primary practice location

48 W 1500 N
Nephi, UT 84648-8900

Mailing address

48 W 1500 N
Nephi, UT 84648-8900
Phone (435) 623-3000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051027000116 UT Practitioner - Diagnostic Radiology 8628095890 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Utah School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Valley Medical CenterGroup PAC ID 2668380460, shared by 5 NPIs, 25 clinicians

Practice addresses (Care Compare)

48 W 1500
Nephi, UT 84648-8900
Phone (435) 623-3200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17441-1205UTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Utah Radiology, PC Diagnostic Radiology CurrentSince Jun 1, 2002 Accepting new patients
Central Valley Medical Center Current Accepting new patients
Central Valley Medical Center Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Mountain Medical Physician Specialists PC Diagnostic Radiology Past Accepting new patients

Locations

48 W 1500 N
Nephi, UT 84648
Phone (435) 623-3000

5334 S Woodrow St
#100
Salt Lake City, UT 84107
Phone (801) 284-1702

Organizations & group practices 4

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 2

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1689675076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 W 1500 N",
            "city": "NEPHI",
            "state": "UT",
            "postal_code": "846488900",
            "telephone_number": "435-623-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 W 1500 N",
            "city": "NEPHI",
            "state": "UT",
            "postal_code": "846488900",
            "telephone_number": "435-623-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAIL",
        "first_name": "CONNIE",
        "middle_name": "MITCHELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "17441-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nephi, UT

Sources for this page

Verify at the official NPI Registry.