Individual provider Active NPI

Symbree Minniear, PA-C

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1720623614
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8993765-1206 Issued in UT
Practice address
82 S 1100 E Ste 303
Salt Lake City, UT 84102-1891
Phone
(801) 533-2002
NPI assigned
Nov 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8993765-1206 UT Primary

Addresses

Primary practice location

82 S 1100 E Ste 303
Salt Lake City, UT 84102-1891

Mailing address

637 E Angie Cir
Midvale, UT 84047-1337

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
I20200514000086 UT Practitioner - Physician Assistant 5991136624 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1380 E Medical Ctr Dr
St George, UT 84790-2123
Phone (435) 251-1000

5121 S Cottonwood St
Murray, UT 84107-5701

Hospital & facility affiliations

  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010
  • LDS Hospital Hospital, Salt Lake City, UT, CCN 460006
  • Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058
  • Intermountain Health Alta View Hospital Hospital, Sandy, UT, CCN 460044

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Group of Utah Inc CurrentSince Feb 27, 2020 Accepting new patients
Ihc Health Services Inc CurrentSince May 1, 2020 Accepting new patients
Ihc Health Services, Inc. CurrentSince May 1, 2020 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

5295 S Commerce Dr
Ste 550
Salt Lake City, UT 84107
Phone (801) 313-4110

5444 S Green St
Salt Lake City, UT 84123
Phone (801) 262-2647

82 S 1100 E
Ste 303
Salt Lake Cty, UT 84102
Phone (801) 533-2002

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

2530 W 4700 S
Ste B8
Taylorsville, UT 84129
Phone (801) 967-5866

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

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 4

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": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1720623614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 E ANGIE CIR",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 S 1100 E STE 303",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021891",
            "telephone_number": "801-533-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNIEAR",
        "first_name": "SYMBREE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8993765-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.