Derek Garn Rodeback, D.O.

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

12005709-1204 Issued in UT

Practice address

1818 Mueller Park Rd
Bountiful, UT 84010-1105

Phone

(453) 414-9858

NPI assigned

Jul 5, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physical Medicine and RehabilitationAlso: Osteopathic Manipulative Medicine

Education

West Virginia School of Osteopathic Medicine, 2013

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)

Hospital & facility affiliations

• St. George Regional Hospital Hospital, St George, UT, CCN 460021

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group NPD
• H&H Chiropractic, LLC

  • Family Medicine Physician
  • Cedar City, UT
  • NPI 1356590319

  Physical Medicine & Rehabilitation

  Medicare reassignment NPD
• Ihc Health Services Inc

  • Orthopaedic Surgery Physician
  • Ogden, UT
  • NPI 1720123383
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Mental Health and Wellness Group

  • Multi-Specialty Clinic/Center
  • Cedar City, UT
  • NPI 1801520499
  NPD (past)
• Breakthrough Regenerative Orthopedics

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Boulder, CO
  • NPI 1497261523
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • St George, UT
  • NPI 1366452880
  Care Compare affiliation

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1053751032",
    "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": "435-688-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 MUELLER PARK RD",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840101105",
            "telephone_number": "453-414-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEBACK",
        "first_name": "DEREK",
        "middle_name": "GARN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-05",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CO",
            "license": "DR.0061855",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "UT",
            "license": "12005709-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley John Robinson, DDS
• John E Robison, M.D.
• Kimberly Ann Robison
• Raven Roche
• Rocky Mountain Dental Associates, P.C.
• Kayleen Rodemack, MS CCC-SLP
• Brian J Rodgers, D. O.
• Rodney M. Jex DPM
• Jessica Rodriguez
• Ashley Megan Rogers

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.
• 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.

Verify at the official NPI Registry.