Individual provider Active NPI

Tiffanee Rae Cravens, FNP-C

  • Family Nurse Practitioner
  • Draper, UT
National Provider Identifier
1720855927
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11122057-4405 Issued in UT
Practice address
13894 S Bangerter Pkwy Ste 200
Draper, UT 84020-5320
Phone
(385) 454-5027
Fax
(801) 742-8381
NPI assigned
Dec 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11122057-4405 UT Primary

Addresses

Primary practice location

13894 S Bangerter Pkwy Ste 200
Draper, UT 84020-5320

Mailing address

716 W Sunny Ledge Dr
Washington, UT 84780-3576

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
I20240104000664 UT Practitioner - Nurse Practitioner 6608227657 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vitalcare Health Services PCGroup PAC ID 2264961861, 46 clinicians

Practice addresses (Care Compare)

1001 N 500
Provo, UT 84604-3305
Phone (505) 320-9952

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11122057-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnectmd Utah PC CurrentSince Feb 1, 2025 Accepting new patients
Gadzoom Health LLC Primary Care CurrentSince Dec 1, 2023 Accepting new patients
Vitalcare Health Services PC CurrentSince Dec 22, 2024 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

6975 S Union Park Ctr
Fl 6
Cottonwood Heights, UT 84047

13894 S Bangerter Pkwy
Ste 200
Draper, UT 84020
Phone (208) 996-3519

3401 N Thanksgiving Way
Ste 190
Lehi, UT 84048
Phone (385) 454-5027

3742 W 2150 N
Ste 150
Lehi, UT 84048
Phone (385) 205-6486

1001 N 500 W
Provo, UT 84604
Phone (505) 320-9952

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.

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": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1720855927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 W SUNNY LEDGE DR",
            "city": "WASHINGTON",
            "state": "UT",
            "postal_code": "847803576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13894 S BANGERTER PKWY STE 200",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205320",
            "telephone_number": "385-454-5027",
            "fax_number": "801-742-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVENS",
        "first_name": "TIFFANEE",
        "middle_name": "RAE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-07",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11122057-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

Verify at the official NPI Registry.