Individual provider Active NPI

Patricia Bearnson, M.D.

  • Gynecology Physician
  • Salt Lake City, UT
National Provider Identifier
1013920677
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
173454-1205 Issued in UT
Practice address
4465 S 900 E Ste 275
Salt Lake City, UT 84124-2469
Phone
(801) 272-6100
Fax
(801) 272-6101
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 173454-1205 UT Primary

Addresses

Primary practice location

4465 S 900 E Ste 275
Salt Lake City, UT 84124-2469

Mailing address

4465 S 900 E Ste 275
Salt Lake City, UT 84124-2469
Phone (801) 272-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
173454-1205UTMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mark's Gynecology Oncology Care LLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1013920677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 S 900 E STE 275",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242469",
            "telephone_number": "801-272-6100",
            "fax_number": "801-272-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 S 900 E STE 275",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242469",
            "telephone_number": "801-272-6100",
            "fax_number": "801-272-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARNSON",
        "first_name": "PATRICIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "UT",
            "license": "173454-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.