Evie Anna Purdom, in Tooele, UT - Medicare Nurse Anesthetist, Certified Registered

Evie Anna Purdom, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Tooele, Utah. Her current practice location is 2055 N Main St, Tooele, Utah. You can reach out to her office (for appointments etc.) via phone at (435) 843-3600.

Evie Anna Purdom is licensed to practice in Utah (license number 12419563-4406) 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 1568161065.

Contact Information

	Evie Anna Purdom,
	2055 N Main St, Tooele, UT 84074-9819
	(435) 843-3600
	Not Available

Map and Direction

Provider's Profile

Full Name	Evie Anna Purdom
Gender	Female
Speciality	Nurse Anesthetist, Certified Registered
Location	2055 N Main St, Tooele, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1568161065
Provider Enumeration Date: 02/23/2023
Last Update Date: 02/23/2023

Medicare PECOS Information:

PECOS PAC ID: 2264806728
Enrollment ID: I20230323001784

Medical Identifiers

Medical identifiers for Evie Anna Purdom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1568161065	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	12419563-4406 (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. Evie Anna Purdom allows following entities to bill medicare on her behalf.

Entity Name	Desert Peak Anesthesia, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518972280 PECOS PAC ID: 6002884996 Enrollment ID: O20040920000002

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. Evie Anna Purdom 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
Evie Anna Purdom, 5283 S Cobble Creek Rd Apt 22j, Murray, UT 84117-6736 Ph: (909) 645-9993	Evie Anna Purdom, 2055 N Main St, Tooele, UT 84074-9819 Ph: (435) 843-3600

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Tooele, UT

Matthew A. Smith, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2055 N Main St., Tooele, UT 84074 Phone: 435-843-3600
Robin B. Bradshaw, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2055 N Main St, Tooele, UT 84074 Phone: 435-843-3600
Annette S Proctor, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2055 N Main St, Tooele, UT 84074 Phone: 435-843-3600
Christopher David Smith, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2055 N Main St, Tooele, UT 84074 Phone: 435-843-8543
Mr. Kyle H Jones, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2055 N Main St, Tooele, UT 84074 Phone: 435-843-3600
Mark E Wilson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2055 N Main St, Tooele, UT 84074 Phone: 435-843-3600

Evie Anna Purdom, - Medicare Nurse Anesthetist, Certified Registered in Tooele, UT