Individual provider Active NPI

Ryan Nimer, DO

  • Anesthesiology Physician
  • Bountiful, UT
National Provider Identifier
1003310426
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
13288648-1204 Issued in UT
Practice address
630 Medical Dr
Bountiful, UT 84010-4908
Phone
(435) 773-0112
NPI assigned
Mar 20, 2018
Last updated
Aug 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 13288648-1204 UT Primary

Addresses

Primary practice location

630 Medical Dr
Bountiful, UT 84010-4908

Mailing address

630 Medical Dr
Bountiful, UT 84010-4908
Phone (435) 773-0112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230510000912 UT Practitioner - Anesthesiology 0749612802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Anesthesia Associates LLCGroup PAC ID 3274590856, 17 clinicians

Practice addresses (Care Compare)

630 Medical Dr
Bountiful, UT 84010-4908
Phone (801) 299-2160

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Western Anesthesia Associates LLC Anesthesiology CurrentSince Apr 19, 2023 Accepting new patients
Arizona Anesthesia Consultants, Inc. Anesthesiology PastSince Jul 1, 2022 Accepting new patients

Locations

630 Medical Dr
North Salt Lake, UT 84010
Phone (801) 292-6231

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1003310426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 MEDICAL DR",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104908",
            "telephone_number": "435-773-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 MEDICAL DR",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104908",
            "telephone_number": "435-773-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMER",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-20",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "13288648-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.