Individual provider Active NPI

Virginia Hutton Manay

  • Family Nurse Practitioner
  • Tooele, UT
National Provider Identifier
1942951553
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13196457-4405 Issued in UT
Practice address
25 S 100 E
Tooele, UT 84074-2116
Phone
(435) 843-3440
NPI assigned
Jan 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.520054 IL
Registered Nurse 163W00000X 25634630 WI
Family Nurse Practitioner 363LF0000X 209026151 IL
Family Nurse Practitioner 363LF0000X 13196457-4405 UT Primary

Addresses

Primary practice location

25 S 100 E
Tooele, UT 84074-2116

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180

Other practice location 1

654 S 900 E
Salt Lake City, UT 84102-3478
Phone (801) 322-5571

Other practice location 2

1276 N Clybourn Ave
Chicago, IL 60610-2003
Phone (312) 337-1073

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
I20241105002819 UT Practitioner - Nurse Practitioner 8426582057 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041.520054ILMDRegistered Nurse
25634630WIMDRegistered Nurse
209026151ILMDFamily Nurse Practitioner
13196457-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Oct 28, 2024 Accepting new patients
Ihc Health Services Inc CurrentSince Oct 28, 2024 Accepting new patients
Planned Parenthood Association of Utah Past Accepting new patients
Planned Parenthood Association of Utah Past Accepting new patients
Planned Parenthood Association of Utah Past Accepting new patients
Planned Parenthood Association of Utah Past Accepting new patients

Locations

5063 S Cottonwood St
Salt Lake City, UT 84107
Phone (801) 507-1800

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

Interoperability endpoints

  • Direct secure messaging: virginia.hutton.p1@direct.ppau.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

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": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1942951553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 S 100 E",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840742116",
            "telephone_number": "435-843-3440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "654 S 900 E",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841023478",
            "country_code": "US",
            "telephone_number": "801-322-5571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1276 N Clybourn Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606102003",
            "country_code": "US",
            "telephone_number": "312-337-1073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANAY",
        "first_name": "VIRGINIA",
        "middle_name": "HUTTON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-14",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.520054",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "25634630",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209026151",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "13196457-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tooele, UT

Sources for this page

Verify at the official NPI Registry.