Active NPI
Robert Wright, PA-C
- Physician Assistant
- Salem, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 12480125-1206
- Practice address
- 555 W Sr 164
Salem, UT 84653-8465 - Phone
- (801) 465-4896
- NPI assigned
- Sep 25, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 12480125-1206 | UT | Primary |
| Medical Physician Assistant | 363AM0700X | 12480125-1206 | UT |
Addresses
Primary practice location
555 W Sr 164
Salem, UT 84653-8465
Mailing address
1055 N 500 W
Attn Credentialing
Provo, UT 84604
Phone (801) 354-8225
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | medreview@reverehealth.com | Central Utah Clinic, P.C. |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
117 N State St
Orem, UT 84057-5509
Phone (801) 607-3130
441 S Redwood Rd
Salt Lake City, UT 84104-3539
Phone (801) 973-2588
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12480125-1206 | UT | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revere Health PC | Current | Accepting new patients | |
| Revere Health PC | Current | Accepting new patients | |
| Utah Imaging Associates Inc | Past | Accepting new patients |
Locations
1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362
1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000
555 W State Road 164
Salem, UT 84653
Phone (801) 465-4896
Organizations & group practices 4
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.
-
- Urgent Care Clinic/Center
- Salt Lake City, UT
- NPI 1851938997
-
- Multi-Specialty Clinic/Center
- Provo, UT
- NPI 1093764805
-
- Multi-Specialty Clinic/Center
- Spanish Fork, UT
- NPI 1851142285
-
- Diagnostic Radiology Physician
- Farmington, UT
- NPI 1629076229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672272000000",
"number": "1073284345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 N 500 W",
"address_2": "ATTN CREDENTIALING",
"city": "PROVO",
"state": "UT",
"postal_code": "84604",
"telephone_number": "801-354-8225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 W SR 164",
"city": "SALEM",
"state": "UT",
"postal_code": "846538465",
"telephone_number": "801-465-4896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRIGHT",
"first_name": "ROBERT",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-09-25",
"last_updated": "2022-12-29",
"certification_date": "2022-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "12480125-1206",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "UT",
"license": "12480125-1206",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "medreview@reverehealth.com",
"affiliation": "Y",
"affiliationName": "Central Utah Clinic, P.C.",
"address_1": "555 W SR 164",
"city": "Salem",
"state": "UT",
"country_code": "US",
"postal_code": "846538465",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Salem, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; 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.