Individual provider Active NPI

Connor Mitchell Udy, PA-C

  • Medical Physician Assistant
  • Brigham City, UT
National Provider Identifier
1063362267
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
14270193-1206 Issued in UT
Practice address
1030 S Medical Dr
Brigham City, UT 84302-3119
Phone
(435) 237-7822
NPI assigned
Jan 29, 2026
Last updated
Jan 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 14270193-1206 UT Primary

Addresses

Primary practice location

1030 S Medical Dr
Brigham City, UT 84302-3119

Mailing address

1030 S Medical Dr
Brigham City, UT 84302-3119
Phone (435) 787-2000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260326003216 UT Practitioner - Physician Assistant 2466937594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1034 W 2450
Perry, UT 84302-4504

PO Box
Suite 30015
Salt Lake City, UT 84130

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14270193-1206UTMDMedical Physician Assistant

Organizations & group practices 1

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": "1769644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1063362267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 S MEDICAL DR",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023119",
            "telephone_number": "435-787-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 S MEDICAL DR",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023119",
            "telephone_number": "435-237-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDY",
        "first_name": "CONNOR",
        "middle_name": "MITCHELL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-29",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "14270193-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brigham City, UT

Sources for this page

Verify at the official NPI Registry.