Active NPI
Anna Douglas Guy, PA-C
- Physician Assistant
- Salt Lake City, UT
National Provider Identifier
1720507932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 11377403-1206
- Practice address
- 100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103 - Phone
- (801) 662-4261
- Fax
- (801) 662-4285
- NPI assigned
- Sep 19, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | AZ | ||
| Physician Assistant | 363A00000X | 11377403-1206 | UT | Primary |
Addresses
Primary practice location
100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other practice location 1
19555 N 59th Ave
Glendale, AZ 85308
Phone (404) 422-8835
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200901001268 | UT | Order and Referring Only - Physician Assistant | 5395162648 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11377403-1206 | UT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725494400000",
"number": "1720507932",
"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": "100 N MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-4261",
"fax_number": "801-662-4285"
}
],
"practiceLocations": [
{
"address_1": "19555 N 59th Ave",
"address_purpose": "LOCATION",
"city": "Glendale",
"state": "AZ",
"postal_code": "85308",
"country_code": "US",
"telephone_number": "404-422-8835",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUY",
"first_name": "ANNA",
"middle_name": "DOUGLAS",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-19",
"last_updated": "2024-09-05",
"certification_date": "2024-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "11377403-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.