Individual provider Active NPI

Teresa Lynne Demille, NP

  • Gerontology Nurse Practitioner
  • St George, UT
National Provider Identifier
1972385177
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
10329169-4405 Issued in UT
Practice address
1380 E Medical Center Dr
St George, UT 84790-2123
Phone
(435) 251-2500
NPI assigned
Oct 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 10329169-4405 UT Primary

Addresses

Primary practice location

1380 E Medical Center Dr
St George, UT 84790-2123

Mailing address

PO Box 27128
SLC, UT 84127-0128
Phone (801) 251-2500

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
I20240209000661 UT Practitioner - Nurse Practitioner 7911340682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1380 E Medical Ctr Dr
St George, UT 84790-2123
Phone (435) 251-1000

Hospital & facility affiliations

  • St. George Regional Hospital Hospital, St George, UT, CCN 460021
  • Intermountain Health Cedar City Hospital Hospital, Cedar City, UT, CCN 460007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Feb 4, 2024 Accepting new patients
Ihc Health Services Inc CurrentSince Feb 4, 2024 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

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

Organizations & group practices 4

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 2

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": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1972385177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-251-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 E MEDICAL CENTER DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847902123",
            "telephone_number": "435-251-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMILLE",
        "first_name": "TERESA",
        "middle_name": "LYNNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-20",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "UT",
            "license": "10329169-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.