Individual provider Active NPI

Steven Andrew Mickelson, F.N.P.

  • Family Nurse Practitioner
  • American Fork, UT
National Provider Identifier
1881696466
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
309049-4405 Issued in UT
Practice address
895 N 900 E
American Fork, UT 84003-9183
Phone
(801) 763-4152
Fax
(801) 763-4571
NPI assigned
Aug 12, 2005
Last updated
Oct 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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 309049-4405 UT Primary

Addresses

Primary practice location

895 N 900 E
American Fork, UT 84003-9183

Mailing address

1565 N 180 W
Lehi, UT 84043-1159
Phone (801) 768-2635

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
I20050106000482 UT Practitioner - Nurse Practitioner 4183672199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of UtahGroup PAC ID 6800797333, 29 clinicians

Practice addresses (Care Compare)

895 N 900
Utah State Developement Center
American Fork, UT 84003-9183
Phone (801) 763-4036

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Utah CurrentSince Aug 29, 2018 Accepting new patients
Utah State Developmental Center CurrentSince Aug 29, 2018 Accepting new patients

Locations

895 N 900 E
American Fork, UT 84003
Phone (801) 756-6022

150 E Center St
Ste 1100
Provo, UT 84606
Phone (801) 374-7011

168 N 1950 W
Ste 201
Slc, UT 84116
Phone (801) 213-2537

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1881696466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 N 180 W",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840431159",
            "telephone_number": "801-768-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 N 900 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840039183",
            "telephone_number": "801-763-4152",
            "fax_number": "801-763-4571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKELSON",
        "first_name": "STEVEN",
        "middle_name": "ANDREW",
        "credential": "F.N.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "309049-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.