Individual provider Active NPI

Colleen Gowans, NP-C

  • Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1770170672
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7538941-4405 Issued in UT
Practice address
1160 E 3900 S Ste 3100
Salt Lake City, UT 84124-1202
Phone
(801) 262-2806
Fax
(801) 262-2023
NPI assigned
Dec 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 7538941-4405 UT Primary

Addresses

Primary practice location

1160 E 3900 S Ste 3100
Salt Lake City, UT 84124-1202

Mailing address

PO Box 281490
Atlanta, GA 30384-1490
Phone (801) 771-7717

Other identifiers 1

IdentifierTypeStateIssuer
1689721219MedicaidUT

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
I20210329001455 UT Practitioner - Nurse Practitioner 9638586183 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountainstar Cardiovascular Services LLCGroup PAC ID 1951404110, 14 clinicians
Redrockrehab PLLCGroup PAC ID 8628514890, 9 clinicians

Practice addresses (Care Compare)

1160 E 3900
Suite 3500
Salt Lake City, UT 84124-1264
Phone (801) 743-4750

8074 S 1300
Sandy, UT 84094-0743
Phone (801) 561-3400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7538941-4405UTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountainstar Cardiovascular Services LLC CurrentSince Oct 4, 2021 Accepting new patients
Redrockrehab PLLC CurrentSince May 1, 2025 Accepting new patients
Mountainstar Cardiology St Marks LLC PastSince Oct 4, 2021 Accepting new patients
Northern Utah Healthcare Corporation PastSince Oct 5, 2021 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

560 W 465 N
Ste 604
Providence, UT 84332
Phone (435) 753-1600

1160 E 3900 S
Ste 3100
Salt Lake City, UT 84124
Phone (801) 262-2806

1160 E 3900 S
Ste 3500
Salt Lake Cty, UT 84124
Phone (801) 476-6900

8074 S 1300 E
Sandy, UT 84094
Phone (801) 561-3400

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1608940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1770170672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 281490",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841490",
            "telephone_number": "801-771-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 E 3900 S STE 3100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241202",
            "telephone_number": "801-262-2806",
            "fax_number": "801-262-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWANS",
        "first_name": "COLLEEN",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-26",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "7538941-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689721219",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.