Individual provider Active NPI

Mattison Kaytlin Collett

  • Physician Assistant
  • Layton, UT
National Provider Identifier
1942929161
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13578958-1206 Issued in UT
Practice address
425 S 100 W
Layton, UT 84041-5356
Phone
(801) 773-4840
Fax
(801) 525-8151
NPI assigned
Aug 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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 13578958-1206 UT Primary

Addresses

Primary practice location

425 S 100 W
Layton, UT 84041-5356

Mailing address

PO Box 337
Layton, UT 84041-0337
Phone (801) 773-4840

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
I20231027002846 UT Practitioner - Physician Assistant 8123474061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians

Practice addresses (Care Compare)

2121 N 1700
Layton, UT 84041-8803
Phone (801) 773-4840

425 S 100
Layton, UT 84041-5356
Phone (801) 773-4840

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13578958-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Memorial Clinic CurrentSince Oct 2, 2023 Accepting new patients
Tanner Memorial Clinic CurrentSince Oct 2, 2023 Accepting new patients
Tanner Memorial Clinic Past Accepting new patients

Locations

425 S 100 W
Layton, UT 84041
Phone (801) 682-8708

Interoperability endpoints

  • Direct secure messaging: mattison.collett.p1@direct.tannerclinic.nextgenshare.com

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": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1942929161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840410337",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S 100 W",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415356",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETT",
        "first_name": "MATTISON",
        "middle_name": "KAYTLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "13578958-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.