Individual provider Active NPI

Matthew Ryan Nelson, APRN

  • Nurse Practitioner
  • Orem, UT
National Provider Identifier
1801377767
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8350156-4405 Issued in UT
Practice address
1974 N 540 E
Orem, UT 84097-2360
Phone
(801) 615-1716
NPI assigned
Aug 28, 2018
Last updated
Apr 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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 8350156-4405 UT Primary

Addresses

Primary practice location

1974 N 540 E
Orem, UT 84097-2360

Mailing address

1974 N 540 E
Orem, UT 84097-2360

Other identifiers 1

IdentifierTypeStateIssuer
1801377767MedicaidUT

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
I20190227002610 UT Practitioner - Nurse Practitioner 1951640440 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

395 W Bulldog Blvd
Suite 205
Provo, UT 84604-3328
Phone (801) 357-1770

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8350156-4405UTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jan 29, 2020 Accepting new patients
Ihc Health Services, Inc. CurrentSince Nov 11, 2018 Accepting new patients
Emergency Physicians Integrated Care, LLC Emergency Medicine CurrentSince Mar 30, 2020 Accepting new patients
Utah Emergency Physicians Emergency Medicine CurrentSince Nov 1, 2019 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Ihc Health Services Inc Emergency Medicine CurrentSince Nov 11, 2018 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

98 N 1100 E
Ste 101
Highland, UT 84003
Phone (801) 492-2273

201 W Layton Pkwy
Layton, UT 84041
Phone (801) 543-6000

1975 N State St
Orem, UT 84057
Phone (801) 714-5000

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

2690 N 600 W
Pleasant View, UT 84414
Phone (801) 786-7911

395 W Cougar Blvd
Ste 205
Provo, UT 84604
Phone (801) 357-1770

3741 W 12600 S
Riverton, UT 84065
Phone (801) 285-2400

8th Ave And C St
Salt Lake City, UT 84143
Phone (801) 350-4110

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417

354 W State Road 73
Saratoga Springs, UT 84045
Phone (801) 341-5200

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

4401 Harrison Blvd
South Ogden, UT 84403
Phone (801) 387-2800

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Organizations & group practices 7

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1801377767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1974 N 540 E",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840972360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1974 N 540 E",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840972360",
            "telephone_number": "801-615-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-28",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "8350156-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801377767",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

Verify at the official NPI Registry.