Active NPI
Alison E. Wynne, ARNP
- Acute Care Nurse Practitioner
- Murray, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 10952123-4405
- Practice address
- Intermountain Healthcare
5121 S Cottonwood St
Murray, UT 84107 - Phone
- (801) 507-4000
- Fax
- (801) 507-4811
- NPI assigned
- Jul 19, 2006
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN00158616 | WA | |
| Acute Care Nurse Practitioner | 363LA2100X | AP30006970 | WA | |
| Acute Care Nurse Practitioner | 363LA2100X | 4330 | SC | |
| Acute Care Nurse Practitioner | 363LA2100X | 10952123-4405 | UT | Primary |
Addresses
Primary practice location
Intermountain Healthcare
5121 S Cottonwood St
Murray, UT 84107
Mailing address
Intermountain Healthcare
5121 S Cottonwood St
Murray, UT 84107
Phone (801) 507-4000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20554U | Other | WA | REGENCE BLUESHIELD |
| 9645250 | Medicaid | WA | |
| 0197481 | Other | WA | LABOR & INDUSTRY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5121 S Cottonwood St
Murray, UT 84107-5701
Phone (801) 507-4800
Hospital & facility affiliations
- Intermountain Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN00158616 | WA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients |
Locations
170 N 1100 E
American Fork, UT 84003
Phone (801) 714-6570
5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998
400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080
5171 S Cottonwood St
South Salt Lake, UT 84107
Phone (801) 507-4000
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.
-
- Multi-Specialty Clinic/Center
- Murray, UT
- NPI 1629260880
-
- Diagnostic Radiology Physician
- Murray, UT
- NPI 1285019737
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Murray, UT
- NPI 1043220650
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540512000000",
"number": "1750300877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "INTERMOUNTAIN HEALTHCARE",
"address_2": "5121 S COTTONWOOD ST",
"city": "MURRAY",
"state": "UT",
"postal_code": "84107",
"telephone_number": "801-507-4000",
"fax_number": "801-507-4811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "INTERMOUNTAIN HEALTHCARE",
"address_2": "5121 S COTTONWOOD ST",
"city": "MURRAY",
"state": "UT",
"postal_code": "84107",
"telephone_number": "801-507-4000",
"fax_number": "801-507-4811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYNNE",
"first_name": "ALISON",
"middle_name": "E.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-19",
"last_updated": "2018-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN00158616",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "WA",
"license": "AP30006970",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "SC",
"license": "4330",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "UT",
"license": "10952123-4405",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUESHIELD",
"identifier": "20554U",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9645250",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRY",
"identifier": "0197481",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.