Active NPI
Paul Fenton, M.D.
- Orthopaedic Surgery Physician
- Draper, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 2606111205
- Practice address
- 96 E Kimballs LN Ste 207
Draper, UT 84020-5025 - Phone
- (801) 576-2300
- Fax
- (419) 537-5600
- NPI assigned
- Jul 27, 2006
- Last updated
- Feb 15, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 35062570 | OH | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 35062570 | OH | |
| Orthopaedic Surgery Physician | 207X00000X | 2606111205 | UT | Primary |
Addresses
Primary practice location
96 E Kimballs LN Ste 207
Draper, UT 84020-5025
Mailing address
PO Box 100253
Atlanta, GA 30384-0253
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0265449 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2000 Health Park Dr
Brentwood, TN 37027-4692
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Knee replacement | 1-10 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 18 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35062570 | OH | MD | Orthopaedic Surgery Physician |
| 2606111205 | UT | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical University of Ohio at Toledo | Current | Accepting new patients | |
| Pediatric Orthopedic Associates LLC | Current | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Mountainstar Medical Group-St. Marks Hospital, LLC | Past | Accepting new patients |
Networks
- UT PPO D-SNP
- UT PPO
Interoperability endpoints
- pfenton38380@direct.utoledo.edu
Organizations & group practices 4
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.
-
dba University of Toledo Medical Center
- General Acute Care Hospital
- Toledo, OH
- NPI 1811971302
-
- Pediatric Orthopaedic Surgery Physician
- Toledo, OH
- NPI 1184018491
-
- Family Medicine Physician
- Salt Lake City, UT
- NPI 1073795258
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Lone Peak Hospital
- General Acute Care Hospital
- Draper, UT
- NPI 1770821571
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644883200000",
"number": "1003820234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 100253",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303840253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 E KIMBALLS LN STE 207",
"city": "DRAPER",
"state": "UT",
"postal_code": "840205025",
"telephone_number": "801-576-2300",
"fax_number": "419-537-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENTON",
"first_name": "PAUL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2022-02-15",
"certification_date": "2022-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "OH",
"license": "35062570",
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "OH",
"license": "35062570",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "UT",
"license": "2606111205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0265449",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.