Active NPI
Susanna Parker
- Physician Assistant
- Bountiful, UT
National Provider Identifier
1922707264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 14242213-1206
- Practice address
- 415 Medical Dr Ste A100
Bountiful, UT 84010-4995 - Phone
- (801) 683-1062
- NPI assigned
- Feb 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 14242213-1206 | UT | Primary |
Addresses
Primary practice location
415 Medical Dr Ste A100
Bountiful, UT 84010-4995
Mailing address
148 N 360 W
Centerville, UT 84014-2139
Phone (385) 226-1821
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24796 | Other | UT | BRPT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14242213-1206 | UT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779408000000",
"number": "1922707264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 N 360 W",
"city": "CENTERVILLE",
"state": "UT",
"postal_code": "840142139",
"telephone_number": "385-226-1821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 MEDICAL DR STE A100",
"city": "BOUNTIFUL",
"state": "UT",
"postal_code": "840104995",
"telephone_number": "801-683-1062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "SUSANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-27",
"last_updated": "2026-05-22",
"certification_date": "2026-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "14242213-1206",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BRPT",
"identifier": "24796",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bountiful, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.