Micah Taniel Duvall, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

361370-4405 Issued in UT

Practice address

10684 S River Front Pkwy
South Jordan, UT 84095-3525

Phone

(801) 816-0332

Fax

(801) 816-0331

NPI assigned

Nov 2, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: micah.stansfield-duvall.1@3391.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/3391/brand/1/csg/1/fhir/r4
• Direct secure messaging: micah.stansfield-duvall.1@30520.direct.athenahealth.com

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.

• Onepeak Southern Oregon PC

  • Family Medicine Physician
  • Medford, OR
  • NPI 1740917558
  Medicare reassignment NPD
• Kenneth L Crump MD PC

  • Family Medicine Physician
  • Orem, UT
  • NPI 1053408450
  NPD (past)
• Revere Health PC

  • Orthopaedic Surgery Physician
  • Salem, UT
  • NPI 1942233986

  Family Medicine

  NPD (past)
• Taylor G Wright PC

  • Podiatrist
  • Layton, UT
  • NPI 1528765575
  NPD (past)
• Traverse Therapy Services

  • Mental Health Counselor
  • Kirkland, WA
  • NPI 1306436274
  NPD (past)

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1730465873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3152N UNIVERSITY AVE 220",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044746",
            "telephone_number": "801-229-1014",
            "fax_number": "801-229-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10684 S RIVER FRONT PKWY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840953525",
            "telephone_number": "801-816-0332",
            "fax_number": "801-816-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVALL",
        "first_name": "MICAH",
        "middle_name": "TANIEL",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-02",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "361370-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley Dunkley, DPT
• Chandler Dunn, DPT
• J. Michael Dunn, D.D.S.
• Loc Hoang Phuc Duong, PHARMD
• Meredith Durrant, PTA
• Kraig Dye
• Bradley N. Dymond, R.PH.
• Dynamic Medical Systems, Inc.
• Dynamic Psychiatry PLLC
• Early Life Child Psychology & Education Center, Inc.

• Family Nurse Practitioner in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.

Verify at the official NPI Registry.