Traci Michelle Allison, FNP
Individual provider Active NPI Nurse Practitioner · Farmington, UT
NPI 1801448790 · NPPES record last updated Jun 6, 2023
Key facts
- NPI
- 1801448790
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 6293896-4405 (UT)
- Practice address
- 991 Shepard LN Ste 200
Farmington, UT 84025-2974 - Phone
- (801) 397-6080
- Fax
- (801) 397-6081
- NPI assigned
- Jul 11, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ogden Clinic PC
Practice addresses (Care Compare)
991 Shepard LN
Suite 200
Farmington, UT 84025-2974
Phone (801) 397-6080
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191113000769 | UT | Practitioner - Nurse Practitioner | 3173955176 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ogden Clinic Specialty Services LLC | Current |
Accepting new patients | |
| Ogden Clinic PC | Family Medicine | Current |
Accepting new patients |
Locations
991 Shepard Ln
Ste 200
Farmington, UT 84025
Phone (801) 397-6080
1370 W 200 N
Kaysville, UT 84037
Phone (385) 888-5320
1351 W 200 N
Kaysville, UT 84037
Phone (385) 209-2928
5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100
6112 S Harrison
South Ogden, UT 84405
Phone (801) 475-3800
1491 E Ridgeline Dr
South Ogden, UT 84405
Phone (317) 790-7550
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JJJGBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 6293896-4405 | UT | Yes |
Addresses
Primary practice location
991 Shepard LN Ste 200
Farmington, UT 84025-2974
Mailing address
PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3500
Other providers in Farmington, UT
- Advanced Health Clinic
- Advanced Wellness Counseling LLC
- Ageless Men'S Health Holdings, LLC
- Robin Ahlstrom
- Michelle Allen
- Isaac Allred
- Jessica R Alsop
- Katelyn Alvey
- Amara Home Medical
- John R Anderson
All providers in Farmington, UT · Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.