Active NPI
Marjory A Bravard, M.D.
- Hospitalist Physician
- Salt Lake City, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 12978644-1205
- 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, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| L-245053 | MA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The General Hospital Corporation | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Rosebud Indian Health Service | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Emerald Medical Practice PC | Current | Accepting new patients | |
| Rosebud Indian Health Service | Current | Accepting new patients | |
| Massachusetts General Physicians Organization Inc | Internal Medicine | Current | 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
- marjory.bravard.1@16299.direct.athenahealth.com
- 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.
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
- Dermatology Physician
- Boston, MA
- NPI 1801874573
Internal Medicine
-
dba Rosebud Indian Health Service Hospital
- General Acute Care Hospital
- Rosebud, SD
- NPI 1194757369
TX
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
-
dba St George Adolescent Partial Hospitalization
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
- Ambulatory Surgical Clinic/Center
- Rosebud, SD
- NPI 1790955128
-
- Specialist
- Park City, UT
- NPI 1962310599
-
- Internal Medicine Physician
- White Plains, NY
- NPI 1528744935
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Intermountain Health Intermountain Medical Center
- General Acute Care Hospital
- Murray, UT
- NPI 1043220650
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; 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.