Individual provider Active NPI

Brad Robert Pulsipher, MSN-FNP

  • Primary Care Nurse Practitioner
  • Riverton, UT
National Provider Identifier
1073872909
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
8211624-4405 Issued in UT
Practice address
12391 S 4000 W
Riverton, UT 84096-7012
Phone
(801) 302-1700
NPI assigned
May 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 8211624-4405 UT Primary
Nurse Practitioner 363L00000X 8211624-4405 UT

Addresses

Primary practice location

12391 S 4000 W
Riverton, UT 84096-7012

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260127002822 UT Practitioner - Nurse Practitioner 7416109376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
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)

12391 S 4000
Riverton, UT 84096-7012
Phone (801) 302-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8211624-4405UTMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Medical Clinic PC CurrentSince Jan 5, 2026 Accepting new patients
Granger Medical Clinic PC CurrentSince Jan 5, 2026 Accepting new patients
Granger Medical Specialists LLC CurrentSince Jan 5, 2026 Accepting new patients
Granger Medical Specialists, LLC CurrentSince Jan 5, 2026 Accepting new patients
Granger Medical Clinic PC Past Accepting new patients
Granger Medical Clinic PC Past Accepting new patients
Herriman Physical Therapy PC Physical Therapist PastSince Jan 2, 2004 Accepting new patients

Locations

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

995 W Levoy Dr
Taylorsville, UT 84123

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

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1336780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1073872909",
    "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": "12391 S 4000 W",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967012",
            "telephone_number": "801-302-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULSIPHER",
        "first_name": "BRAD",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "MSN-FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-12",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "UT",
            "license": "8211624-4405",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "8211624-4405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

Verify at the official NPI Registry.