Individual provider Active NPI

Chantelle Lena Elmer, DNP

  • Acute Care Nurse Practitioner
  • Payson, UT
National Provider Identifier
1770149528
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
6092068-4405 Issued in UT
Practice address
1000 E 100 N
Payson, UT 84651-1600
Phone
(801) 465-7000
NPI assigned
May 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 6092068-4405 UT Primary

Addresses

Primary practice location

1000 E 100 N
Payson, UT 84651-1600

Mailing address

969 S 640 E
Payson, UT 84651-1628

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
I20191003001580 UT Practitioner - Nurse Practitioner 2961733068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Regional Hospitalists LLCGroup PAC ID 4789807165, 119 clinicians

Practice addresses (Care Compare)

1000 E 100
Payson, UT 84651-1600
Phone (801) 783-5011

Hospital & facility affiliations

  • Mountain View Hospital Hospital, Payson, UT, CCN 460013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6092068-4405UTMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Regional Hospitalists LLC CurrentSince Aug 23, 2019 Accepting new patients
Reveal Medspa CurrentSince May 26, 2024 Accepting new patients
Utah Regional Hospitalists LLC CurrentSince Aug 23, 2019 Accepting new patients

Locations

750 W 800 N
Orem, UT 84057
Phone (801) 714-6000

1000 E 100 N
Payson, UT 84651
Phone (801) 465-7000

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 964-3111

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": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1770149528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 S 640 E",
            "city": "PAYSON",
            "state": "UT",
            "postal_code": "846511628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 100 N",
            "city": "PAYSON",
            "state": "UT",
            "postal_code": "846511600",
            "telephone_number": "801-465-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMER",
        "first_name": "CHANTELLE",
        "middle_name": "LENA",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-17",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "6092068-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Payson, UT

Sources for this page

Verify at the official NPI Registry.