Individual provider Active NPI

Shiloh C Manning, FNP

  • Family Nurse Practitioner
  • Roy, UT
National Provider Identifier
1972536001
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3434864405 Issued in UT
Practice address
5640 S 3500 W
Roy, UT 84067-9158
Phone
(801) 773-2838
Fax
(801) 773-3025
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X N29783 ID
Family Nurse Practitioner 363LF0000X 3434864405 UT Primary

Addresses

Primary practice location

5640 S 3500 W
Roy, UT 84067-9158

Mailing address

1055 N 500 W Attn: Credentialing
Provo, UT 84604-3305
Phone (801) 354-8225

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address medreview@reverehealth.com Central Utah Clinic, P.C.

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
I20050708000720 UT Practitioner - Nurse Practitioner 1759365927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

2850 N 2000
Suite 101
Farr West, UT 84404-9230
Phone (801) 528-5095

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N29783IDMDFamily Nurse Practitioner
3434864405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Sep 24, 2012 Accepting new patients
Revere Health PC CurrentSince Sep 24, 2012 Accepting new patients
Care-Plus PC Past Accepting new patients

Locations

2850 N 2000 W
Ste 201
Farr West, UT 84404
Phone (801) 354-0941

698 12th St
Ogden, UT 84404
Phone (801) 475-3700

2850 N 2000 W
Ste 101
Ogden, UT 84404
Phone (801) 528-5095

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1937 W 5700 S
Roy, UT 84067
Phone (801) 773-9380

5640 S 3500 W
Roy, UT 84067
Phone (801) 773-2838

Interoperability endpoints

  • Direct secure messaging: shilohmanning@cuccu.allscriptsdirect.net

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.

Hospital & facility affiliations 3

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1972536001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W ATTN: CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5640 S 3500 W",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679158",
            "telephone_number": "801-773-2838",
            "fax_number": "801-773-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "SHILOH",
        "middle_name": "C",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "N29783",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "3434864405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Central Utah Clinic, P.C.",
            "address_1": "5640 S 3500 W",
            "city": "Roy",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840679158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roy, UT

Sources for this page

Verify at the official NPI Registry.