Whitney Petterborg, RDN in Providence, UT - Medicare Dietitian, Registered Provider

Whitney Petterborg, RDN is a medicare enrolled "Dietitian, Registered" provider in Providence, Utah. Her current practice location is 517 W 100 N Ste 110, Providence, Utah. You can reach out to her office (for appointments etc.) via phone at (435) 755-6075.

Whitney Petterborg is licensed to practice in Utah (license number 86118135) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1003580002.

Contact Information

	Whitney Petterborg, RDN
	517 W 100 N Ste 110, Providence, UT 84332-9826
	(435) 755-6075
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Whitney Petterborg
Gender	Female
Speciality	Dietitian, Registered
Location	517 W 100 N Ste 110, Providence, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003580002
Provider Enumeration Date: 08/03/2021
Last Update Date: 08/03/2021

Medicare PECOS Information:

PECOS PAC ID: 6103283833
Enrollment ID: I20231010002489

Medical Identifiers

Medical identifiers for Whitney Petterborg such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003580002	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	86118135 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Whitney Petterborg allows following entities to bill medicare on her behalf.

Provider Name	Ihc Health Services Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Whitney Petterborg is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Whitney Petterborg, RDN 172 Meadow Cir, Logan, UT 84321-5095 Ph: () -	Whitney Petterborg, RDN 517 W 100 N Ste 110, Providence, UT 84332-9826 Ph: (435) 755-6075

Reviews and Comments

Dietitian, Registered in Providence, UT

Mrs. Lauren Marie Stowers Rasmussen, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 220 N Spring Creek Pkwy Unit 19, Providence, UT 84332 Phone: 435-755-3300
Jennifer Cloward, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 445 N 100 E, Providence, UT 84332 Phone: 801-680-4678
Jeannine Anne Groll, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 517 W 100 N Ste 110, Providence, UT 84332 Phone: 435-755-6061 Fax: 435-994-8362

Whitney Petterborg, RDN - Medicare Dietitian in Providence, UT