Active NPI
Deeann Cervantez, NP
- Pediatric Nurse Practitioner
- Salt Lake City, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 108619-4405
- Practice address
- 100 N Mario Capecchi Dr Ste 3550
Salt Lake City, UT 84113-1103 - Phone
- (801) 662-5555
- NPI assigned
- Jan 3, 2018
- Last updated
- Nov 11, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 108619-4405 | UT | Primary |
| Pediatric Urology Physician | 2088P0231X | 108619-4405 | UT |
Addresses
Primary practice location
100 N Mario Capecchi Dr Ste 3550
Salt Lake City, UT 84113-1103
Mailing address
100 N Mario Capecchi Dr Ste 3550
Salt Lake City, UT 84113-1103
Phone (801) 662-5555
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dcervantez285606@direct.med.utah.edu | Direct | University of Utah |
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
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Pediatric Services | Current | Accepting new patients | |
| University of Utah Pediatric Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Pediatric Services | Current | Accepting new patients | |
| University of Utah Pediatric Services | Past | Accepting new patients |
Locations
100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
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.
-
- General Practice Physician
- Salt Lake City, UT
- NPI 1114321981
-
dba Department of Pediatrics
- Pediatrics Physician
- Salt Lake City, UT
- NPI 1487018974
-
dba University of Utah Rehabilitation & Wellness Program
- Physical Medicine & Rehabilitation Physician
- Salt Lake City, UT
- NPI 1275937146
-
dba University of Utah Hospital Radiology Department
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1598169419
-
dba Pediatric Infectious Disease
- Pediatric Infectious Diseases Physician
- Salt Lake City, UT
- NPI 1285098855
-
dba Pediatric Genetics
- Clinical Genetics (M.D.) Physician
- Salt Lake City, UT
- NPI 1861856619
-
dba Pediatric Inpatient Services Riverton
- Pediatrics Physician
- Riverton, UT
- NPI 1043671985
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636588800000",
"number": "1841707569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N MARIO CAPECCHI DR STE 3550",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-5555",
"fax_number": "801-662-5547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N MARIO CAPECCHI DR STE 3550",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CERVANTEZ",
"first_name": "DEEANN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-03",
"last_updated": "2021-11-11",
"certification_date": "2021-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "UT",
"license": "108619-4405",
"primary": true
},
{
"code": "2088P0231X",
"taxonomy_group": "",
"desc": "Urology, Pediatric Urology",
"state": "UT",
"license": "108619-4405",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dcervantez285606@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "University of Utah",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.