Individual provider Active NPI

Mayra Ibeth Vences, NP-C

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1841844057
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
82272178-4405 Issued in UT
Practice address
1146 N Antilles Dr
Salt Lake City, UT 84116-4656
Phone
(801) 673-8082
NPI assigned
Jul 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 82272178-4405 UT Primary

Addresses

Primary practice location

1146 N Antilles Dr
Salt Lake City, UT 84116-4656

Mailing address

1146 N Antilles Dr
Salt Lake City, UT 84116-4656
Phone (801) 673-8082

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
I20191107000026 UT Practitioner - Nurse Practitioner 9436581741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

54 N 800
Salt Lake City, UT 84116-3326
Phone (801) 408-8654

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82272178-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Nov 4, 2019 Accepting new patients
Ihc Health Services, Inc. CurrentSince Nov 4, 2019 Accepting new patients

Locations

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

54 N 8th W
Salt Lake City, UT 84116
Phone (801) 359-0901

1105 W 1000 N
Slc, UT 84116
Phone (801) 364-2434

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.

NPI Registry JSON

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1841844057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 N ANTILLES DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841164656",
            "telephone_number": "801-673-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1146 N ANTILLES DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841164656",
            "telephone_number": "801-673-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENCES",
        "first_name": "MAYRA",
        "middle_name": "IBETH",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "82272178-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.