SAMUEL R EVERETT PA-C
NPI 1104224815
Clinical Nurse Specialist - Psychiatric/Mental Health in Murray, UT

Q: What is Samuel Everett's NPI number?

The NPI number for Samuel Everett is 1104224815. It was assigned to this individual provider in the NPPES registry on December 11, 2014. The provider is also known as Mallory Danielson Pa-C.

Q: What is Samuel Everett's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Psychiatric/Mental Health, with taxonomy code 364SP0808X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Everett was last updated on October 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 11, 2014PECOS Enrolled

154 E MYRTLE AVE STE 204, MURRAY, UT 84107(801) 369-8989(801) 704-9741 Get Directions Write a Review

NPPES record last updated: October 12, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 12, 2023, Sep 6, 2023, Sep 18, 2020 and 1 more (4 updates tracked since 2019).

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About Samuel R Everett Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL R EVERETT PA-C (NPI 1104224815) is an individual psychiatric/mental health provider in Murray, Utah, licensed in Utah (9492493-1206) and active in the NPI registry since December 2014. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1104224815

Entity TypeIndividualMale

Primary Taxonomy364SP0808X

Provider Legal NameSAMUEL R EVERETTCredential: PA-C

Location Address154 E MYRTLE AVE STE 204Murray, UT 84107-4850

Mailing Address154 E Myrtle Ave Ste 204Murray, UT 84107-4850 · (801) 369-8989 · Fax (801) 704-9741

Phone(801) 369-8989

Fax(801) 704-9741

Sole ProprietorNo

Enumeration DateDecember 11, 2014

Last NPPES UpdateOctober 12, 20234 updates tracked since enumeration

NPPES CertifiedOctober 12, 2023

✔ NPI 1104224815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical Nurse Specialist · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code364SP0808X

License✔ Licensed in UT · 9492493-1206

Also ListedPhysician AssistantTaxonomy 363A00000X · License 9492493-1206 (UT)

154 E MYRTLE AVE STE 204, Murray, UT 84107

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Other Names 1

Former Name (1)Mallory Danielson Pa-c

Secondary Practice Locations 2

Location 1710 E 200 S Apt 3BSalt Lake City, UT 84102-2253 · Phone (385) 376-3739 · Fax (385) 360-9959

Location 2140 W 2100 S Ste 110Salt Lake City, UT 84115-1855 · Phone (385) 376-3739 · Fax (385) 360-3739

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel R Everett Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$125.70 typical visit price

range $54.34 – $166.03

Typical copayment $31.42 (range $13.58 – $41.50)

Most-billed visit code 99204

Established Patient

$96.35 typical visit price

range $17.23 – $135.20

Typical copayment $24.08 (range $4.30 – $33.80)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Adult Major Depressive Disorder (MDD): Suicide Risk Assessment

0%172 patients

Documentation of Current Medications in the Medical Record

32%1,194 patients1/55-star benchmark: 100%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

47%102 patients2/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 2% · 335 patients

2%335 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SEVON TAROIAN

Social Worker (Clinical)

154 E MYRTLE AVE STE 204
MURRAY, UT 84107

Salt Lake County (801) 369-8989

LORRIE MICHELLE BELNAP L.C.S.W.

Social Worker (Clinical)

154 E MYRTLE AVE STE 204
MURRAY, UT 84107

Salt Lake County (801) 369-8989

LINDSAY HELM

Physician Assistant

154 E MYRTLE AVE STE 204
MURRAY, UT 84107

Salt Lake County (801) 369-8989

THERESA IPOLITO CSW

Social Worker (Clinical)

154 E MYRTLE AVE STE 204
SALT LAKE CITY, UT 84107

Salt Lake County (801) 369-8989

KATHRYN EVANS DOWDEN APRN

Nurse Practitioner (Psychiatric/Mental Health)

154 E MYRTLE AVE STE 204
MURRAY, UT 84107

Salt Lake County (801) 369-8989

SCOTT MICHAEL SALOMONE M.D.

Psychiatry & Neurology (Psychiatry)

154 E MYRTLE AVE STE 204
MURRAY, UT 84107

Salt Lake County (520) 874-2857

MARINA DANIELLE FOWLER

Social Worker (Clinical)

154 E MYRTLE AVE STE 204
MURRAY, UT 84107

Salt Lake County (385) 216-5178

LINDSEY PAIGE GAVIN DNP, APRN, PMHNP-BC

Nurse Practitioner (Psychiatric/Mental Health)

154 E MYRTLE AVE STE 204
MURRAY, UT 84107

Salt Lake County (801) 369-8989

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Everett's NPI number?

The NPI number for Samuel Everett is 1104224815. It was assigned to this individual provider in the NPPES registry on December 11, 2014. The provider is also known as Mallory Danielson Pa-C.

Where is Samuel Everett located?

Samuel Everett practices at 154 E Myrtle Ave Ste 204, Murray, UT 84107. The listed phone number is (801) 369-8989.

What is Samuel Everett's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Psychiatric/Mental Health, with taxonomy code 364SP0808X.

Is Samuel Everett enrolled in Medicare?

Yes. Samuel Everett is registered in the Medicare PECOS enrollment system.

What insurance does Samuel Everett accept?

Health plans from CareSource and Molina Healthcare list Samuel Everett as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samuel Everett was last updated on October 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.