MRS. CERISSA NICOLE JOHNSON HETH – Nurse Practitioner, NPI 1952040974
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,655 NURSE PRACTITIONER in UT
Provider Addresses for MRS. CERISSA NICOLE JOHNSON HETH
4602 W 1100 S
WEST POINT, UT 840157779
Phone: (801) 859-5856
Type: Mailing
PO BOX 27128
SALT LAKE CITY, UT 841270128
Phone:
Type: Mailing
975 CHAMBERS ST
SOUTH OGDEN, UT 844034591
Phone: (801) 387-6200
Fax: (801) 387-6234
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-01-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230125000992 | I | Nurse Practitioner | UT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 146 | 133 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 90 | 80 | $0 |
| 87428 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza | 34 | 34 | $0 |
| 81003 | Automated urinalysis test | 32 | 27 | $0 |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | 16 | 16 | $0 |
Insurance plans in this area (ZIP 84015)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | UT | |
| Family Practice | UT | |
| Physician Assistant | UT | |
| Internal Medicine, Endocrinology | UT | |
| Family Practice | UT | |
| - | UT | |
| O T O L A R Y N G O L O G Y | UT | |
| Physician Assistant | AZ | |
| Qualified Audiologist | UT | |
| Certified Registered Nurse Anesthetist (Crna) | UT |
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