Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Terry Russell Van Wormer, PA-C

Individual provider Physician Assistant · NPI 1467439505

Terry Russell Van Wormer, PA-C is a Physician Assistant in Layton, Utah. Qualified in 1999, 27 years ago. Practices with Tanner Memorial Clinic, a 252-clinician group and accepts Medicare assignment.

Years since qualifying
27
In the registry since
2005
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2121 N 1700 W
Layton, UT 84041-8803
Phone: (801) 773-4840
Fax: (801) 525-8151
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1467439505
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 29, 2005
Last updated in NPPESJuly 21, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Tanner Memorial Clinic — 252 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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