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Whitney Petterborg , RDN

Dietitian, Registered • Providence, UT

Active NPI 1003580002 Individual Practitioner Female Practitioner Accepts Medicare assignment
Practice location in NPPES

517 W 100 N Ste 110
Providence, UT 843329826

Call 4357556075 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

517 W 100 N Ste 110

Providence, UT 843329826

Telephone 4357556075
Organization at the Same NPPES Address or Phone
Bear Lake Community Health Center, Inc. Facility NPI 1649546938

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Ihc Health Services Inc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2019

Years since graduation

7 years (graduated 2019)

CMS Doctors and Clinicians data list 2019 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2021

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Whitney Petterborg has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Compared with the same specialty in Providence and Utah

3 active clinicians are listed under Dietitian, Registered with a practice address in Providence, UT (684 in Utah).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-07-28
Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

License # reported to NPPES UT 86118135

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Utah Division of Professional Licensing.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL

Medicare Enrollment ID

I20231010002489

Enrollment State Jurisdiction

UT

PECOS Control ID

6103283833

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Ihc Health Services Inc

390 N Main St, Bountiful, UT 840106046

Phone: 8012949933

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

4 listed
Benjamin Kadas , APN

Nurse Practitioner - Psychiatric/Mental Health

NPI 1912975186

Advanced Practice Nurse

Naomi Landry , PA-C

Physician Assistant

NPI 1851916464

Physician Assistant (Certified)

NPI 1508020363

Doctor of Optometry

Nathan Zurcher

Nurse Practitioner - Psychiatric/Mental Health

NPI 1164085676

Career & Practice History

NPI enumerated August 03, 2021.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from August 2021 to August 2026.

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NPI Administrative Meta

NPI Number: 1003580002
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 03, 2021
Last Update: August 03, 2021
Sole Proprietor: Yes

Mailing Address

172 Meadow Cir

Logan, UT 843215095

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.