Active NPI
Joshua Vance, PA
- Physician Assistant
- American Fork, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10474683-1206
- Practice address
- 1175 E 50 S Ste 211
American Fork, UT 84003-2845 - Phone
- (801) 418-0870
- Fax
- (801) 418-0871
- NPI assigned
- Sep 13, 2017
- Last updated
- Nov 27, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 10474683-1206 | UT | |
| Physician Assistant | 363A00000X | 10474683-1206 | UT | Primary |
Addresses
Primary practice location
1175 E 50 S Ste 211
American Fork, UT 84003-2845
Mailing address
1055 N 500 W
Attn: Credentialing
Provo, UT 84604-3305
Phone (801) 354-8225
Other practice location 1
3000 N Triumph Blvd Ste 100
Lehi, UT 84043-4999
Phone (801) 418-0870
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | medreview@reverehealth.com | Revere Health PC |
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
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1175 E 50
Suite 211
American Fork, UT 84003-2845
Phone (801) 418-0807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10474683-1206 | UT | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revere Health PC | Current | Accepting new patients | |
| Revere Health PC | Current | Accepting new patients |
Locations
1175 E 50 S
Ste 211
American Fork, UT 84003
Phone (801) 418-0807
3000 N Triumph Blvd
Ste 100
Lehi, UT 84043
Phone (385) 345-3555
1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000
1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362
Interoperability endpoints
- joshuavance@cuccu.allscriptsdirect.net
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1891214540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 N 500 W",
"address_2": "ATTN: CREDENTIALING",
"city": "PROVO",
"state": "UT",
"postal_code": "846043305",
"telephone_number": "801-354-8225",
"fax_number": "801-418-0941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 E 50 S STE 211",
"city": "AMERICAN FORK",
"state": "UT",
"postal_code": "840032845",
"telephone_number": "801-418-0870",
"fax_number": "801-418-0871"
}
],
"practiceLocations": [
{
"address_1": "3000 N Triumph Blvd Ste 100",
"address_purpose": "LOCATION",
"city": "Lehi",
"state": "UT",
"postal_code": "840434999",
"country_code": "US",
"telephone_number": "801-418-0870",
"fax_number": "801-418-0871",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANCE",
"first_name": "JOSHUA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-13",
"last_updated": "2023-11-27",
"certification_date": "2020-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "UT",
"license": "10474683-1206",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "10474683-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "medreview@reverehealth.com",
"affiliation": "Y",
"affiliationName": "Revere Health PC",
"address_1": "1175 E 50 S Ste 211",
"city": "American Fork",
"state": "UT",
"country_code": "US",
"postal_code": "840032845",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in American Fork, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.