Individual provider Active NPI

Samuel Christensen

  • Family Medicine Physician
  • St George, UT
National Provider Identifier
1780114934
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11539237-1204 Issued in UT
Practice address
25 N 100 E Ste 102
St George, UT 84770-7369
Phone
(435) 986-2565
NPI assigned
Jun 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11539237-1204 UT Primary

Addresses

Primary practice location

25 N 100 E Ste 102
St George, UT 84770-7369

Mailing address

25 N 100 E Ste 102
St George, UT 84770-7369

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200616001226 UT Practitioner - Family Practice 0547512964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Utah Community Health CenterGroup PAC ID 5799692398, 28 clinicians

Practice addresses (Care Compare)

2276 E Riverside Dr
St George, UT 84790-2636
Phone (435) 986-2565

Hospital & facility affiliations

  • St. George Regional Hospital Hospital, St George, UT, CCN 460021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Utah Community Health Center CurrentSince Jul 1, 2020 Accepting new patients
Southwest Utah Community Health Center Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Southwest Utah Community Health Center Past Accepting new patients

Locations

245 E 680 S
Cedar City, UT 84720
Phone (435) 867-7654

391 N 200 W
Hurricane, UT 84737
Phone (435) 359-9525

25 N 100 E
Ste 102
St George, UT 84770
Phone (435) 879-5105

168 N 100 E
Ste 101
St George, UT 84770
Phone (435) 986-2565

2276 E Riverside Dr
St George, UT 84790
Phone (435) 986-2565

Interoperability endpoints

  • Direct secure messaging: samuel.christensen@swuchc.eclinicaldirectplus.com

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": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1780114934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N 100 E STE 102",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847707369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N 100 E STE 102",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847707369",
            "telephone_number": "435-986-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-19",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "11539237-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.