NPIMap

Organization Active NPI

Layton Ambulatory Anesthesia, Inc

  • Anesthesiology Physician
  • Layton, UT
National Provider Identifier
1013950286
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
LAYTON AMBULATORY ANESTHESIA, INC
Practice address
1544 W Antelope Drive
Layton, UT 84041-1146
Phone
(801) 773-3339
Fax
(801) 773-6727
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Authorized official

Name
Bryan Holbrook, MD
Title
Group President
Phone
(801) 499-6464

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X UT Primary

Addresses

Primary practice location

1544 W Antelope Drive
Layton, UT 84041-1146

Mailing address

P.O. Box 3810
Salt Lake City, UT 84110-3810
Phone (801) 727-2069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050714000874 UT Part B Supplier - Clinic/Group Practice 6406882000 Receives reassigned benefits from 1 practitioner
Practice locations: Layton, UT

National Provider Directory

National Provider Directory

Locations

150 W Civic Center Dr
Ste 200
Sandy, UT 84070
Phone (801) 727-2056

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1013950286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3810",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103810",
            "telephone_number": "801-727-2069",
            "fax_number": "678-285-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1544 W ANTELOPE DRIVE",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411146",
            "telephone_number": "801-773-3339",
            "fax_number": "801-773-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAYTON AMBULATORY ANESTHESIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "HOLBROOK",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "GROUP PRESIDENT",
        "authorized_official_telephone_number": "801-499-6464",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.