Active NPI
Desiree Funk, PA-C
- Medical Physician Assistant
- Orem, UT
National Provider Identifier
1841440542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 7118251
- Practice address
- 155 N 400 W # B6
Orem, UT 84057-1909 - Phone
- (801) 224-1300
- NPI assigned
- Sep 30, 2008
- Last updated
- Sep 30, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 7118251 | UT | Primary |
Addresses
Primary practice location
155 N 400 W # B6
Orem, UT 84057-1909
Mailing address
602 N Bella Vista Dr
Orem, UT 84097-5430
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7118251 | UT | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| After Hours Medical LLC, Dba Medallus Medical | Current | Accepting new patients | |
| After Hours Medical LLC, Dba Medallus Medical | Current | Accepting new patients |
Locations
1126 E Draper Pkwy
Draper, UT 84020
Phone (801) 545-0600
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.
-
dba Mid-Utah Family Medicine
- Rural Health Clinic/Center
- Gunnison, UT
- NPI 1255924486
-
dba After Hours Medical-South Jordan Clinic
- Urgent Care Clinic/Center
- South Jordan, UT
- NPI 1780786525
-
dba After Hours Holladay Clinic
- Urgent Care Clinic/Center
- Draper, UT
- NPI 1992078349
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222732800000",
"number": "1841440542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "602 N BELLA VISTA DR",
"city": "OREM",
"state": "UT",
"postal_code": "840975430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 N 400 W # B6",
"city": "OREM",
"state": "UT",
"postal_code": "840571909",
"telephone_number": "801-224-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNK",
"first_name": "DESIREE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-30",
"last_updated": "2008-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "UT",
"license": "7118251",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orem, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.