Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Elizabeth J Avery, PA

Individual provider Physician Assistant · NPI 1134828965

Elizabeth J Avery, PA is a Physician Assistant in Provo, Utah. Qualified in 2025, 1 year ago. Practices with Revere Health PC, a 410-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
1
Licensed in
UT
In the registry since
2023
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1055 N 500 W Ste 205 Bldg C
Provo, UT 84604-3305
Phone: (801) 429-8095
Fax: (801) 354-8265
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 14240564-1206 (UT)

Record details

NPI number1134828965
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedMarch 1, 2023
Last updated in NPPESSeptember 17, 2025
Certification dateSeptember 17, 2025
Mailing address1055 N 500 W, Att: Credentialing, Provo, UT 84604-3305

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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