Individual provider Active NPI

Wendy Jane Frey, APRN

  • Nurse Practitioner
  • South Salt Lake, UT
National Provider Identifier
1912488347
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4914568-4405 Issued in UT
Practice address
3702 S State St Ste 107
South Salt Lake, UT 84115-5096
Phone
(801) 288-2634
Fax
(801) 288-1186
NPI assigned
Aug 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4914568-4405 UT Primary

Addresses

Primary practice location

3702 S State St Ste 107
South Salt Lake, UT 84115-5096

Mailing address

3702 S State St Ste 107
South Salt Lake, UT 84115-5096
Phone (801) 288-2634

Other practice location 1

4101 W Pioneer Pkwy Ste 103
West Valley, UT 84120-2050
Phone (801) 288-2634

Other practice location 2

12523 S Creek Meadow Rd Ste 111
Riverton, UT 84065-7291
Phone (801) 288-2634

Other identifiers 1

IdentifierTypeStateIssuer
1912488347MedicaidUT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wfrey31407@direct.acumenmd.com

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
I20190117003904 UT Practitioner - Nurse Practitioner 9537405170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Regional Hospitalists LLCGroup PAC ID 4789807165, 119 clinicians

Practice addresses (Care Compare)

8074 S 1300
Sandy, UT 84094-0743
Phone (801) 561-3400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Regional Hospitalists LLC CurrentSince May 1, 2024 Accepting new patients
Utah Regional Hospitalists LLC CurrentSince May 1, 2024 Accepting new patients

Locations

8074 S 1300 E
Sandy, UT 84094
Phone (801) 561-3400

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 964-3111

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.

Hospital & facility affiliations 7

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": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1912488347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 S STATE ST STE 107",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841155096",
            "telephone_number": "801-288-2634",
            "fax_number": "801-288-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 S STATE ST STE 107",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841155096",
            "telephone_number": "801-288-2634",
            "fax_number": "801-288-1186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4101 W Pioneer Pkwy Ste 103",
            "address_purpose": "LOCATION",
            "city": "West Valley",
            "state": "UT",
            "postal_code": "841202050",
            "country_code": "US",
            "telephone_number": "801-288-2634",
            "fax_number": "801-288-1186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12523 S Creek Meadow Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Riverton",
            "state": "UT",
            "postal_code": "840657291",
            "country_code": "US",
            "telephone_number": "801-288-2634",
            "fax_number": "801-288-1186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREY",
        "first_name": "WENDY",
        "middle_name": "JANE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "4914568-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912488347",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wfrey31407@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "3702 S State St Ste 107",
            "city": "South Salt Lake",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841155096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Salt Lake, UT

Sources for this page

Verify at the official NPI Registry.