Aspen Family Medicine PLLC
Organization Active NPI Nurse Practitioner · American Fork, UT
NPI 1730787458 · NPPES record last updated May 29, 2024
Key facts
- NPI
- 1730787458
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- ASPEN FAMILY MEDICINE PLLC
- Practice address
- 1062 E 220 S
American Fork, UT 84003-5504 - Phone
- (385) 333-7633
- Fax
- (833) 989-2351
- NPI assigned
- Oct 14, 2020
- Organization subpart
- No
Authorized official
- Name
- Tyson Boltz
- Title
- Owner
- Phone
- (385) 333-7633
Practitioners 1
-
Arthur Tyson Boltz, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211008002512 | UT | Part B Supplier - Clinic/Group Practice | 7416355250 |
Receives reassigned benefits from 1 practitioner Practice locations: American Fork, UT |
National Provider Directory
Locations
36 N 1100 E
#36C
American Fork, UT 84003
Interoperability endpoints
- https://api.platform.athenahealth.com/22889/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | Yes |
Addresses
Primary practice location
1062 E 220 S
American Fork, UT 84003-5504
Mailing address
1062 E 220 S
American Fork, UT 84003-5504
Phone (385) 333-7633
Other providers in American Fork, UT
- Maria Arruda
- Matthew E Artigas
- Sarah Lyn Ashby
- Allison Ashton
- Aspen Counseling Services
- Aspen Peaks School District
- Martin Asplund
- Associated Fresh Markets Inc
- Athenian Eacademy
- Raymond Douglas Atkinson
All providers in American Fork, UT · Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.