Active NPI
Glenn Manuel Ratmeyer, MD
- Pediatrics Physician
- Salt Lake City, UT
National Provider Identifier
1053171322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 14240750-1205
- Practice address
- 30 North Mario Capecchi Dr, 3Rd Floor
Salt Lake City, UT 84112 - Phone
- (801) 581-7606
- NPI assigned
- Mar 21, 2024
- Sex
- Male
- 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 | 14240750-1205 | UT | |
| Pediatrics Physician | 208000000X | 14240750-1205 | UT | Primary |
Addresses
Primary practice location
30 North Mario Capecchi Dr, 3Rd Floor
Salt Lake City, UT 84112
Mailing address
30 North Mario Capecchi Dr, 3Rd Floor
Salt Lake City, UT 84112
Phone (801) 581-7606
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251017003036 | UT | Order and Referring Only - Internal Medicine | 9830686203 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14240750-1205 | UT | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758585600000",
"number": "1053171322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 NORTH MARIO CAPECCHI DR, 3RD FLOOR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84112",
"telephone_number": "801-581-7606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 NORTH MARIO CAPECCHI DR, 3RD FLOOR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84112",
"telephone_number": "801-581-7606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RATMEYER",
"first_name": "GLENN",
"middle_name": "MANUEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-21",
"last_updated": "2025-09-23",
"certification_date": "2025-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "UT",
"license": "14240750-1205",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "UT",
"license": "14240750-1205",
"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 Sep 23, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.