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MINDY CROCKETT RDN, CD
NPI 1225297419
Dietitian, Registered in Provo, UT

Active since June 03, 2008
395 W BULLDOG BLVD, PROVO, UT 84604(801) 357-8143(801) 357-8329 Get Directions Write a Review

NPPES record last updated: June 30, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mindy Crockett Rdn, Cd NPPES

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

MINDY CROCKETT RDN, CD (NPI 1225297419) is an individual dietitian, registered in Provo, Utah, licensed in Utah (6434151-4901) and active in the NPI registry since June 2008.

NPPES Registry Identity

NPI1225297419
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMINDY CROCKETTCredential: RDN, CD
Location Address395 W BULLDOG BLVDProvo, UT 84604-3311
Mailing Address395 W Bulldog Blvd Fl 4Provo, UT 84604-3311 · (801) 357-8143 · Fax (801) 357-8329
Phone(801) 357-8143
Fax(801) 357-8329
Sole ProprietorNo
Enumeration DateJune 3, 2008
Last NPPES UpdateJune 30, 2022
NPPES CertifiedJune 30, 2022
✔ NPI 1225297419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in UT · 6434151-4901
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
395 W BULLDOG BLVD, Provo, UT 84604
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mindy Crockett Rdn, Cd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Mindy Crockett reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ihc Health Services Inc
Same address
Physical Medicine & Rehabilitation
395 W BULLDOG BLVD STE 502
Provo, UT 84604
  • Reassigned Medicare billing, Utah enrollment
  • 1,729 clinicians in this Medicare group
NPI 1265630693 (801) 357-8818

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

ETHAN MARK NIELSEN PA
Physician Assistant
395 W BULLDOG BLVD
PROVO, UT 84604
Utah County (801) 357-7081
KAYLAN DIANE OLSEN NP
Nurse Practitioner
395 W BULLDOG BLVD
PROVO, UT 84604
Utah County (801) 357-7081
RAMIE BEST FNP
Nurse Practitioner
395 W BULLDOG BLVD
PROVO, UT 84604
Utah County (801) 357-7081
KRYSTAL JENNIFER BISCHOFF FNP
Nurse Practitioner
395 W BULLDOG BLVD
PROVO, UT 84604
Utah County (801) 357-7081
JAMES MICHAEL FEENEY MD FACC
Internal Medicine (Interventional Cardiology)
395 W BULLDOG BLVD
PROVO, UT 84604
Utah County (801) 357-7081
IHC HEALTH SERVICES INC
Internal Medicine (Sports Medicine)
395 W BULLDOG BLVD
PROVO, UT 84604
Utah County (801) 357-4141
DR. VLAD ANDREI RADULESCU MD
Internal Medicine (Cardiovascular Disease)
395 W BULLDOG BLVD
PROVO, UT 84604
Utah County (801) 357-7081
KAYLA J REAM PA
Physician Assistant
395 W BULLDOG BLVD
PROVO, UT 84604
Utah County (801) 357-7081

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 Mindy Crockett's NPI number?

The NPI number for Mindy Crockett is 1225297419. It was assigned to this individual provider in the NPPES registry on June 3, 2008.

Where is Mindy Crockett located?

Mindy Crockett practices at 395 W Bulldog Blvd, Provo, UT 84604. The listed phone number is (801) 357-8143.

What is Mindy Crockett's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Mindy Crockett enrolled in Medicare?

Yes. Mindy Crockett is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mindy Crockett's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mindy Crockett reassigns Medicare benefits to Ihc Health Services Inc (Provo, UT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mindy Crockett's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mindy Crockett was last updated on June 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.