Walter Montgomery Wootton, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8802245-1206 Issued in UT

Practice address

379 N 500 W
Vernal, UT 84078-1956

Phone

(435) 789-1165

NPI assigned

Sep 24, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uintah Basin Medical CenterGroup PAC ID 0244131944, 62 clinicians

Utah Regional Hospitalists LLCGroup PAC ID 4789807165, 119 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uintah Basin Medical Center Hospital, Roosevelt, UT, CCN 460019
• Lakeview Hospital Hospital, Bountiful, UT, CCN 460042

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Uintah Basin Medical Center

  • General Acute Care Hospital
  • Roosevelt, UT
  • NPI 1871556217
  Medicare reassignment Care Compare group NPD
• Utah Regional Hospitalists LLC

  • Hospitalist Physician
  • Murray, UT
  • NPI 1962821223
  Medicare reassignment Care Compare group
• Northeastern Utah Medical Group

  • Family Medicine Physician
  • Roosevelt, UT
  • NPI 1982664199
  Medicare reassignment NPD
• Uintah Basin Medical Center

  • Community/Retail Pharmacy
  • Vernal, UT
  • NPI 1285420414
  NPD
• Utah Regional Hospitalists LLC

  • Hospitalist Physician
  • Idaho Falls, ID
  • NPI 1740715507
  NPD
• Uintah Basin Medical Center

  • Rural Health Clinic/Center
  • Vernal, UT
  • NPI 1760180566
  NPD (past)

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

• Hospital Corporation of Utah

  • General Acute Care Hospital
  • Bountiful, UT
  • NPI 1528010451
  Care Compare affiliation
• Uintah Basin Medical Center

  • General Acute Care Hospital
  • Roosevelt, UT
  • NPI 1871556217
  Care Compare affiliation
• Uintah Basin Medical Center

  • General Acute Care Hospital
  • Vernal, UT
  • NPI 1881447571
  Care Compare affiliation
• Uintah Basin Medical Center

  • Physical Therapy Clinic/Center
  • Ballard, UT
  • NPI 1912750662

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1891121661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W 300 N",
            "address_2": "# 75-3",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840662336",
            "telephone_number": "435-725-7448",
            "fax_number": "435-722-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 N 500 W",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840781956",
            "telephone_number": "435-789-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTTON",
        "first_name": "WALTER",
        "middle_name": "MONTGOMERY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-24",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8802245-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Winn, SSW
• Tracy Lee Winterton, FNP-BC
• Jordan Witbeck
• Kirk Woodward, M.D.
• Sarah Jane Woody, FNP
• Briana Workman
• Wright Brothers Orthodontics PC
• Fredrick Wright, LCSW
• Heather Lynn Wright
• William Duke Wright, DDS

• Physician Assistant in Vernal, UT
• Providers in Vernal, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.