Individual provider Active NPI

Joshua Vance, PA

  • Physician Assistant
  • American Fork, UT
National Provider Identifier
1891214540
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10474683-1206 Issued in UT
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
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171025003602 UT Practitioner - Physician Assistant 1658647201 Reassigns benefits to 1 organization

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
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

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

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Sep 12, 2017 Accepting new patients
Revere Health PC CurrentSince Sep 12, 2017 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) 345-3155

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

Interoperability endpoints

  • Direct secure messaging: 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 and National Provider Directory roles.

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

Verify at the official NPI Registry.