Individual provider Active NPI

Mary-Virginia Hye-Jin Parker, NP

  • Nurse Practitioner
  • Layton, UT
National Provider Identifier
1952936668
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9404087-4405 Issued in UT
Practice address
2121 N 1700 W
Layton, UT 84041-8803
Phone
(801) 777-3484
Fax
(801) 519-3164
NPI assigned
Mar 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 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 9404087-4405 UT Primary

Addresses

Primary practice location

2121 N 1700 W
Layton, UT 84041-8803

Mailing address

2121 N 1700 W Ste a
Layton, UT 84041-8804
Phone (801) 773-4840

Other practice location 1

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

Other identifiers 1

IdentifierTypeStateIssuer
1952936668MedicaidUT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mparker31433@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
I20200402000513 UT Practitioner - Nurse Practitioner 1658700224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Memorial Clinic Current Accepting new patients
Tanner Memorial Clinic Family Medicine CurrentSince Jan 29, 2024 Accepting new patients
Tanner Memorial Clinic CurrentSince Jan 29, 2024 Accepting new patients
Rosenberg Cooley Metcalf LC Past Accepting new patients
Liberty Dialysis-Woods Cross LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: maryvirginia.parker.p1@direct.tannerclinic.nextgenshare.com

Organizations & group practices 5

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 4

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": "1583193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1952936668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 N 1700 W STE A",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840418804",
            "telephone_number": "801-773-4840",
            "fax_number": "801-519-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 N 1700 W",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840418803",
            "telephone_number": "801-777-3484",
            "fax_number": "801-519-3164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3702 S State St Ste 107",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841155096",
            "country_code": "US",
            "telephone_number": "801-288-2634",
            "fax_number": "801-288-1186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "MARY-VIRGINIA",
        "middle_name": "HYE-JIN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-03",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "9404087-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952936668",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mparker31433@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "3702 S State St Ste 107",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841155096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.