Individual provider Active NPI

Michael Atkerson Worthington, APRN

  • Family Nurse Practitioner
  • Taylorsville, UT
National Provider Identifier
1891259164
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8760558-4405 Issued in UT
Practice address
3845 W 4700 S
Taylorsville, UT 84129-3454
Phone
(801) 840-2100
Fax
(801) 840-2119
NPI assigned
Jan 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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 8760558-4405 UT Primary

Addresses

Primary practice location

3845 W 4700 S
Taylorsville, UT 84129-3454

Mailing address

3845 W 4700 S
Taylorsville, UT 84129-3454
Phone (801) 840-2100

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
I20200213001297 UT Practitioner - Nurse Practitioner 1759717655 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Dec 25, 2019 Accepting new patients
Ihc Health Services Inc CurrentSince Dec 25, 2019 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

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

3845 W 4700 S
West Valley City, UT 84129
Phone (801) 840-2020

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": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1891259164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3845 W 4700 S",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841293454",
            "telephone_number": "801-840-2100",
            "fax_number": "801-840-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3845 W 4700 S",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841293454",
            "telephone_number": "801-840-2100",
            "fax_number": "801-840-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHINGTON",
        "first_name": "MICHAEL",
        "middle_name": "ATKERSON",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-30",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "8760558-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorsville, UT

Sources for this page

Verify at the official NPI Registry.