Joseph Everitt, PA-C
Individual provider Active NPI Physician Assistant · Mount Pleasant, UT
NPI 1760132153 · NPPES record last updated Oct 30, 2024
Key facts
- NPI
- 1760132153
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 14172263-1206 (UT)
- Practice address
- 1075 S Highway 89
Mount Pleasant, UT 84647 - Phone
- (435) 462-2044
- Fax
- (435) 462-2043
- NPI assigned
- Mar 28, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of Utah School of Medicine, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Revere Health PC
Granger Medical Clinic PC
Practice addresses (Care Compare)
1055 N 500
Provo, UT 84604-3305
12391 S 4000
Riverton, UT 84096-7012
Phone (801) 302-1700
2965 W 3500
West Valley City, UT 84119-3602
Phone (801) 965-3600
512 E Lakeview Pkwy
Provo, UT 84606-7311
Phone (801) 812-5591
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241112004111 | UT | Practitioner - Physician Assistant | 3274067384 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Granger Medical Clinic PC | Current |
Accepting new patients | |
| Revere Health PC | Current |
Accepting new patients | |
| Granger Medical Clinic PC | Current |
Accepting new patients | |
| Granger Medical Specialists, LLC | Current |
Accepting new patients | |
| Revere Health PC | Current |
Accepting new patients |
Locations
1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000
12391 S 4000 W
Riverton, UT 84096
Phone (801) 302-1700
555 W State Road 164
Salem, UT 84653
Phone (801) 465-4896
995 W Levoy Dr
Taylorsville, UT 84123
3181 W 9000 S
West Jordan, UT 84088
Phone (801) 352-5900
2965 W 3500 S
West Valley City, UT 84119
Phone (801) 965-3505
3725 W 4100 S
West Valley City, UT 84120
Phone (801) 965-3545
Interoperability endpoints
- josepheveritt@cuccu.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 14172263-1206 | UT | Yes |
| Medical Physician Assistant | 363AM0700X | 14172263-1206 | UT |
Addresses
Primary practice location
1075 S Highway 89
Mount Pleasant, UT 84647
Mailing address
1055 N 500 W
Attn Credentialing
Provo, UT 84604
Phone (801) 354-8225
Other practice location 1
2965 W 3500 S
West Valley City, UT 84119-3602
Phone (801) 965-3600
Other providers in Mount Pleasant, UT
- Katherine Elizabeth Edgar
- Elite Ankle & Foot
- Dakota Ellett
- Derek Ray Ellgen
- Sabrina Ellsworth
- Douglas G Ford
- David Fox
- Korinne Kjar Fuentes
- Mandy Gardenheir
- Britney Gardner
All providers in Mount Pleasant, UT · Physician Assistant in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.