Individual provider Active NPI

Rebecca J Simpson, PA-C

  • Physician Assistant
  • SLC, UT
National Provider Identifier
1720159403
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1863 Issued in NE
Practice address
344 E 100 S
SLC, UT 84111-1700
Phone
(801) 428-4257
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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 494 WY
Medical Physician Assistant 363AM0700X PA269 ID
Physician Assistant 363A00000X 1863 NE Primary

Addresses

Primary practice location

344 E 100 S
SLC, UT 84111-1700

Mailing address

344 E 100 S
SLC, UT 84111-1700
Phone (801) 428-4257

Other identifiers 1

IdentifierTypeStateIssuer
PA1Q5OtherIDBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1863NEMDDental Hygienist
PA269IDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Odyssey House Inc CurrentSince Dec 12, 2023 Accepting new patients
G Adrian Dean MD Inc Past Accepting new patients

Locations

117 W 400 S
Slc, UT 84101
Phone (385) 200-0110

340 E 100 S
Slc, UT 84111
Phone (801) 322-3397

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1720159403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 E 100 S",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841111700",
            "telephone_number": "801-428-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 E 100 S",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841111700",
            "telephone_number": "801-428-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "REBECCA",
        "middle_name": "J",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "494",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA269",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "PA1Q5",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in SLC, UT

Sources for this page

Verify at the official NPI Registry.