Alyssa Ann Dean
Individual provider Active NPI Nurse Practitioner · Hurricane, UT
NPI 1912411307 · NPPES record last updated Dec 8, 2021
Key facts
- NPI
- 1912411307
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 6422358-4405 (UT)
- Practice address
- 75 N 2260 W
Hurricane, UT 84737-2034 - Phone
- (435) 635-6500
- Fax
- (435) 635-6549
- NPI assigned
- Nov 22, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
5373 S Green St
Suite 400
Murray, UT 84123-4740
Phone (833) 442-2670
Hospital & facility affiliations
- Intermountain Health Home Health - St. George
- St. George Regional Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180725000521 | UT | Practitioner - Nurse Practitioner | 1557618311 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current |
Accepting new patients | |
| Ihc Health Services Inc | Past | Accepting new patients |
Locations
5373 S Green St
Ste 400
Salt Lake City, UT 84123
Phone (801) 442-2615
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 6422358-4405 | UT | Yes |
| Emergency Registered Nurse | 163WE0003X | 6422358-3102 | UT |
Addresses
Primary practice location
75 N 2260 W
Hurricane, UT 84737-2034
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other providers in Hurricane, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.