Individual provider Active NPI

Rebekah Hewett Clifford, MD

  • Dermatology Physician
  • Murray, UT
National Provider Identifier
1053511584
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
6888037-1205 Issued in UT
Practice address
5323 S Woodrow St Ste 201
Murray, UT 84107-5846
Phone
(801) 965-3600
NPI assigned
Jul 23, 2007
Last updated
Feb 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 6888037-1205 UT Primary

Addresses

Primary practice location

5323 S Woodrow St Ste 201
Murray, UT 84107-5846

Mailing address

2965 W 3500 S
West Valley City, UT 84119-3602
Phone (801) 965-3600

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
I20160816002499 UT Practitioner - Dermatology 4486949377 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical School at Houston, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians

Practice addresses (Care Compare)

2965 W 3500
West Valley City, UT 84119-3602
Phone (801) 965-3600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions746
Removal of nail tissue1-10
Removal or shaving of skin growth196
Skin biopsy15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6888037-1205UTMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Medical Clinic PC Current Accepting new patients
Granger Medical Specialists LLC CurrentSince Nov 1, 2020 Accepting new patients
Granger Medical Clinic, PC CurrentSince Dec 26, 2023 Accepting new patients
Granger Medical Specialists, LLC CurrentSince Nov 1, 2020 Accepting new patients
Granger Medical Clinic PC Past Accepting new patients

Locations

12391 S 4000 W
Riverton, UT 84096
Phone (801) 302-1700

995 W Levoy Dr
Taylorsville, UT 84123

7181 S Campus View Dr
West Jordan, UT 84084
Phone (801) 965-3505

7181 S Campus View Dr
Ste 200
West Jordan, UT 84084
Phone (801) 965-3505

2965 W 3500 S
West Valley City, UT 84119
Phone (801) 965-3505

3725 W 4100 S
West Valley City, UT 84120
Phone (801) 965-3545

Networks

  • UT PPO D-SNP
  • UT PPO

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1053511584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 S WOODROW ST STE 201",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075846",
            "telephone_number": "801-965-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "REBEKAH",
        "middle_name": "HEWETT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "6888037-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.