AMY LYNN DALTON
NPI 1104433606
Nurse Practitioner in Provo, UT

Q: What is Amy Dalton's NPI number?

The NPI number for Amy Dalton is 1104433606. It was assigned to this individual provider in the NPPES registry on September 28, 2020.

Q: What is Amy Dalton's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Amy Dalton was last updated on February 5, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 28, 2020PECOS Enrolled

1055 N 500 W BLDG A, PROVO, UT 84604(801) 812-5033(801) 418-0941 Get Directions Write a Review

NPPES record last updated: February 5, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 5, 2021, Sep 28, 2020 (2 updates tracked since 2020).

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About Amy Lynn Dalton NPPES

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

AMY LYNN DALTON (NPI 1104433606) is an individual nurse practitioner in Provo, Utah, licensed in Utah (10105657-4405) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Orem.

NPPES Registry Identity

NPI1104433606

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameAMY LYNN DALTON

Location Address1055 N 500 W BLDG AProvo, UT 84604-3305

Mailing Address1055 N 500 WProvo, UT 84604-3305 · (801) 354-8225 · Fax (801) 418-0941

Phone(801) 812-5033

Fax(801) 418-0941

Sole ProprietorNo

Enumeration DateSeptember 28, 2020

Last NPPES UpdateFebruary 5, 20212 updates tracked since enumeration

NPPES CertifiedFebruary 5, 2021

✔ NPI 1104433606 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in UT · 10105657-4405

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

1055 N 500 W BLDG A, Provo, UT 84604

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Secondary Practice Location 1

Location 1530 E 700 SOrem, UT 84097-6340 · Phone (808) 333-7805

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah, Select Health and more.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)

Amy Lynn Dalton 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 84604 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

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

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.

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Other Providers at the Same Location NPPES 20

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

BEVERLY LARAINE WILLIAMS

Social Worker (Clinical)