Individual provider Active NPI

Mary Ann Abrahamson, NP

  • Acute Care Nurse Practitioner
  • Woods Cross, UT
National Provider Identifier
1699145029
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4737515-8900 Issued in UT
Practice address
971 W 1200 S
Woods Cross, UT 84087-2007
Phone
(435) 849-1469
NPI assigned
Sep 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4737515-8900 UT Primary

Addresses

Primary practice location

971 W 1200 S
Woods Cross, UT 84087-2007

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180
Phone (435) 849-1469

Other names 1

  • Mary Ann Webb Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151027002882 UT Practitioner - Nurse Practitioner 2961711213 Reassigns benefits to 1 organization
I20190125000302 HI Practitioner - Nurse Practitioner 2961711213 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4737515-8900UTMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Acuity Care Services CurrentSince Apr 7, 2019 Accepting new patients
University of Utah Acuity Care Services CurrentSince Apr 7, 2019 Accepting new patients
The Makana North Shore Clinic CurrentSince Oct 13, 2018 Accepting new patients

Locations

4488 Hanalei Plantation Rd
Princeville, HI 96722
Phone (808) 320-7300

175 N Medical Dr
#U
Salt Lake City, UT 84112
Phone (801) 585-7575

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: mabrahamson342903@direct.med.utah.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1699145029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180",
            "telephone_number": "435-849-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 W 1200 S",
            "city": "WOODS CROSS",
            "state": "UT",
            "postal_code": "840872007",
            "telephone_number": "435-849-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAMSON",
        "first_name": "MARY ANN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-28",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "4737515-8900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ANN",
            "last_name": "WEBB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woods Cross, UT

Sources for this page

Verify at the official NPI Registry.