Individual provider Active NPI

Robert Gordon Sheen, NP-C

  • Family Nurse Practitioner
  • Provo, UT
National Provider Identifier
1770559387
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3435044405 Issued in UT
Practice address
1034 N 500 W
Provo, UT 84604-3380
Phone
(801) 357-4930
NPI assigned
Feb 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3435044405 UT Primary

Addresses

Primary practice location

1034 N 500 W
Provo, UT 84604-3380

Mailing address

7385 Bromley Rd
West Jordan, UT 84084-2738
Phone (801) 561-3452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060128000053 UT Practitioner - Nurse Practitioner 1658385612 Reassigns benefits to 2 organizations
I20220405000451 ID Practitioner - Nurse Practitioner 1658385612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians
Urgent Specialty Associates of Utah PLLCGroup PAC ID 3476904442, 12 clinicians

Practice addresses (Care Compare)

1200 E 3900
Salt Lake City, UT 84124-1300
Phone (561) 997-0821

3100 Channing Way
Idaho Falls, ID 83404-7533
Phone (208) 529-6111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3435044405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intensive Care Consortium Inc Family CurrentSince Dec 29, 2021 Accepting new patients
Urgent Specialty Associates of Utah PLLC CurrentSince Nov 1, 2023 Accepting new patients
University of Utah Emergency Physicians Past Accepting new patients
University of Utah Emergency Physicians Past Accepting new patients

Locations

3100 Channing Way
Idaho Falls, ID 83404
Phone (208) 227-2100

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

1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

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 2

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770559387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7385 BROMLEY RD",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840842738",
            "telephone_number": "801-561-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043380",
            "telephone_number": "801-357-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEN",
        "first_name": "ROBERT",
        "middle_name": "GORDON",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "3435044405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.