Individual provider Active NPI

Marjory A Bravard, M.D.

  • Hospitalist Physician
  • Salt Lake City, UT
National Provider Identifier
1023338498
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
12978644-1205 Issued in UT
Practice address
8TH Ave C St
Salt Lake City, UT 84143-0001
Phone
(801) 507-4384
Fax
(801) 507-4398
NPI assigned
Jun 8, 2010
Last updated
Jun 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L-245053 MA
Hospitalist Physician 208M00000X 12978644-1205 UT Primary

Addresses

Primary practice location

8TH Ave C St
Salt Lake City, UT 84143-0001

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 507-4384

Other practice location 1

1743 S Sidewinder Drive Unit 114
Park City, UT 84060
Phone (307) 840-9834

Other practice location 2

Massachusetts General Hospital
55 Fruit St.
Boston, MA 02114
Phone (617) 726-2865

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguest_Service Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, UT, CO, TX4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20130801000180 MA Practitioner - HospitalistPractitioner - Internal Medicine 4880855097 Reassigns benefits to 2 organizations
I20221116003123 UT Practitioner - Hospitalist 4880855097 Reassigns benefits to 2 organizations
I20240415002196 CO Practitioner - Internal Medicine 4880855097 Reassigns benefits to 1 organization
I20240425002281 TX Practitioner - Internal Medicine 4880855097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Tufts University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

8 TH Ave and C St
Salt Lake City, UT 84143-0001
Phone (801) 408-3446

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L-245053MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Aug 1, 2013 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Rosebud Indian Health Service CurrentSince Mar 18, 2024 Accepting new patients
Ihc Health Services Inc CurrentSince Jan 1, 2023 Accepting new patients
Emerald Medical Practice PC CurrentSince Mar 14, 2024 Accepting new patients
Rosebud Indian Health Service CurrentSince Mar 18, 2024 Accepting new patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Aug 1, 2013 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Cloud Health Medical Group, P.a. Internal Medicine Past Accepting new patients
Emerald City Medical Practice PA Past Accepting new patients

Locations

4770 Baseline Rd
Ste 200
Boulder, CO 80303
Phone (307) 840-9834

801 Adlai Stevenson Dr
Springfield, IL 62703
Phone 4153603833 ext. 03833

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

1160 Dublin Rd
Ste 400
Columbus, OH 43215
Phone (502) 439-2617

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1441 Ute Blvd
Ste 370
Park City, UT 84098
Phone (307) 840-9834

1743 Sidewinder Dr
Unit 114
Park City, UT 84060
Phone (307) 840-9834

8th Ave And C St
Salt Lake City, UT 84143
Phone (801) 350-4110

8th Ave C St
Salt Lake City, UT 84143
Phone (801) 269-2500

Interoperability endpoints

  • Direct secure messaging: marjory.bravard.1@16299.direct.athenahealth.com
  • Direct secure messaging: marjory.bravard.1@30093.direct.athenahealth.com

Organizations & group practices 10

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": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1023338498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-507-4384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8TH AVE C ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841430001",
            "telephone_number": "801-507-4384",
            "fax_number": "801-507-4398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1743 S Sidewinder Drive Unit 114",
            "address_purpose": "LOCATION",
            "city": "Park City",
            "state": "UT",
            "postal_code": "84060",
            "country_code": "US",
            "telephone_number": "307-840-9834",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Massachusetts General Hospital",
            "address_2": "55 Fruit St.",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02114",
            "country_code": "US",
            "telephone_number": "617-726-2865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAVARD",
        "first_name": "MARJORY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "L-245053",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "UT",
            "license": "12978644-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.