Individual provider Active NPI

Savannah Hancock, PA

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1710684667
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14046439-1206 Issued in UT
Practice address
5121 S Cottonwood St
Salt Lake City, UT 84107-5701
Phone
(801) 507-6415
NPI assigned
Feb 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14046439-1206 UT Primary
Physician Assistant 363A00000X PA2831 NV
Medical Physician Assistant 363AM0700X

Addresses

Primary practice location

5121 S Cottonwood St
Salt Lake City, UT 84107-5701

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
I20240923001616 UT Practitioner - Physician Assistant 3274996913 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

5121 S Cottonwood St
Murray, UT 84107-5701

5131 S Cottonwood St
Murray, UT 84107-5701
Phone (801) 507-3888

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

8 TH Ave and C St
LDS Hosp Eeg Phys GRP
Salt Lake City, UT 84143
Phone (801) 507-7000

Hospital & facility affiliations

  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010

Merit-based Incentive Payment System (MIPS)

Final score
65.71 of 100Reported as group
Quality
22.52
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Apr 1, 2025 Accepting new patients
Ihc Health Services, Inc. CurrentSince Oct 28, 2024 Accepting new patients
Ihc Health Services Inc CurrentSince Oct 28, 2024 Accepting new patients

Locations

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

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

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

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 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": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1710684667",
    "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": "5121 S COTTONWOOD ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "801-507-6415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "SAVANNAH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-10",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14046439-1206",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2831",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.