Individual provider Active NPI

Adam Alex Nelson, PA

  • Physician Assistant
  • West Jordan, UT
National Provider Identifier
1902239478
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2655 W 9000 S
West Jordan, UT 84088-8542
Phone
(801) 566-8304
Fax
(801) 566-8330
NPI assigned
Aug 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X UT Primary

Addresses

Primary practice location

2655 W 9000 S
West Jordan, UT 84088-8542

Mailing address

2655 W 9000 S
West Jordan, UT 84088-8542

Other practice location 1

10654 S River Heights Dr Ste 210
South Jordan, UT 84095-5541
Phone (801) 569-1456

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
I20131028001204 UT Practitioner - Physician Assistant 5597990648 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jordan Valley Dermatology Center LLCGroup PAC ID 5890019707, 5 clinicians
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

10654 S River Heights Dr
Suite 210
South Jordan, UT 84095-5541
Phone (801) 569-1456

2655 W 9000
West Jordan, UT 84088-8542
Phone (801) 568-9933

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

  • Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058
  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Nov 4, 2019 Accepting new patients
Ihc Health Services Inc CurrentSince Nov 4, 2019 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

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

2655 W 9000 S
West Jordan, UT 84088
Phone (801) 256-6343

Interoperability endpoints

  • Direct secure messaging: anelson@jvdc.emadirect.md

Organizations & group practices 5

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.

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": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1902239478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840888542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840888542",
            "telephone_number": "801-566-8304",
            "fax_number": "801-566-8330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10654 S River Heights Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "South Jordan",
            "state": "UT",
            "postal_code": "840955541",
            "country_code": "US",
            "telephone_number": "801-569-1456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ADAM",
        "middle_name": "ALEX",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-19",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

Verify at the official NPI Registry.