Individual provider Active NPI

Jon R Robison, M.D.

  • Anesthesiology Physician
  • Providence, UT
National Provider Identifier
1013967801
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
363085-1205 Issued in UT
Practice address
560 W 465 N Ste 604
Providence, UT 84332-8006
Phone
(435) 753-1600
Fax
(435) 753-9521
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 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 363085-1205 UT Primary

Addresses

Primary practice location

560 W 465 N Ste 604
Providence, UT 84332-8006

Mailing address

560 W 465 N Ste 604
Providence, UT 84332-8006
Phone (435) 753-1600

Other identifiers 1

IdentifierTypeStateIssuer
1013967801MedicaidUT

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
I20110124000051 UT Practitioner - Anesthesiology 0941203152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Saint Louis University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interwest Anesthesia Associates LLCGroup PAC ID 0042293359, 29 clinicians

Practice addresses (Care Compare)

2380 N 400
North Logan, UT 84341-6000
Phone (435) 713-9700

55 E Golf Course Rd
Logan, UT 84321-0001
Phone (435) 760-3734

Hospital & facility affiliations

  • Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015
  • Cache Valley Hospital Hospital, North Logan, UT, CCN 460054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
363085-1205UTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interwest Anesthesia Associates LLC Anesthesiology CurrentSince Jul 1, 2001 Accepting new patients
Interwest Comprehensive Pain Center PastSince Feb 27, 2006 Accepting new patients

Locations

810 S 100 W
Ste 120
Logan, UT 84321
Phone (435) 527-2100

55 E Golf Course Rd
Logan, UT 84321
Phone (435) 760-3734

274 N Main St
Logan, UT 84321
Phone (435) 213-9278

1400 N 500 E
North Logan, UT 84341
Phone (435) 716-1000

560 W 465 N
Ste 604
Providence, UT 84332
Phone (435) 753-1600

65 N Gateway Dr
Ste 3
Providence, UT 84332
Phone (435) 213-6563

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1013967801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W 465 N STE 604",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843328006",
            "telephone_number": "435-753-1600",
            "fax_number": "435-753-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W 465 N STE 604",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843328006",
            "telephone_number": "435-753-1600",
            "fax_number": "435-753-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBISON",
        "first_name": "JON",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "363085-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013967801",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, UT

Sources for this page

Verify at the official NPI Registry.