Individual provider Active NPI

Pamela Sorensen, PA-C

  • Physician Assistant
  • St George, UT
National Provider Identifier
1992972616
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2168631206 Issued in UT
Practice address
295 S 1470 E Ste 200
Saint George, UT 84790-1762
Phone
(435) 628-1662
Fax
(435) 628-1722
NPI assigned
May 12, 2008
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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 2168631206 UT Primary

Addresses

Primary practice location

295 S 1470 E Ste 200
Saint George, UT 84790-1762

Mailing address

295 S 1470 E Ste 200
Saint George, UT 84790-1762
Phone (435) 628-1662

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
I20081211000079 UT Practitioner - Physician Assistant 9537220348 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2168631206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Obstetrics and Gynecology, PC CurrentSince Feb 10, 2015 Accepting new patients
Valley Obstetrics and Gynecology, P.C. CurrentSince Feb 10, 2015 Accepting new patients
Valley Obstetrics and Gynecology, PC PastSince Aug 1, 2011 Accepting new patients

Locations

585 N 500 W
Provo, UT 84601
Phone (801) 374-1801

585 N 500 W
Ste 500
Provo, UT 84601

295 S 1470 E
Ste 200
St George, UT 84790
Phone (435) 628-1662

515 S 300 E
Ste 206
St George, UT 84770
Phone (435) 628-1662

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1992972616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 S 1470 E STE 200",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847901762",
            "telephone_number": "435-628-1662",
            "fax_number": "435-628-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 S 1470 E STE 200",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847901762",
            "telephone_number": "435-628-1662",
            "fax_number": "435-628-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "PAMELA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "2168631206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.