Individual provider Active NPI

Grace M O'Brien, DO

  • Family Medicine Physician
  • South Ogden, UT
National Provider Identifier
1093702003
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
180186-1204 Issued in UT
Practice address
6112 S 1550 E
South Ogden, UT 84405-5007
Phone
(801) 475-3800
Fax
(801) 475-3801
NPI assigned
Oct 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 180186-1204 UT Primary

Addresses

Primary practice location

6112 S 1550 E
South Ogden, UT 84405-5007

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3800

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
I20040330000285 UT Practitioner - Family Practice 9537051891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
College of Osteo Med of the Pacific at Pomona, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ogden Clinic PCGroup PAC ID 9638078033, 104 clinicians

Practice addresses (Care Compare)

4650 Harrison Blvd
Ogden, UT 84403-4303
Phone (801) 475-3010

4700 Harrison Blvd
Ogden, UT 84403-4303
Phone (801) 475-3010

5495 S 500
Suite 310
Ogden, UT 84405-7409
Phone (801) 475-3100

6112 S 1550
Ogden, UT 84405-5007
Phone (801) 475-3800

Hospital & facility affiliations

  • Atlas Home Care Home health agency, Layton, UT, CCN 467232
  • Applegate Homecare Home health agency, South Ogden, UT, CCN 467025
  • Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
  • Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005
  • Holy Cross Hospital-Davis Hospital, Layton, UT, CCN 460041
  • Intermountain Health Layton Hospital Hospital, Layton, UT, CCN 460061

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ogden Clinic PC Family Medicine CurrentSince Jun 16, 2003 Accepting new patients
Ogden Clinic Specialty Services LLC Current Accepting new patients

Locations

4350 Washington Blvd
Ogden, UT 84403
Phone (801) 476-5100

5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100

1159 12th St
Ogden, UT 84404
Phone (801) 475-3700

4650 Harrison Blvd
Ogden, UT 84403
Phone (801) 475-3481

5430 S 1900 W
Ste G1
Roy, UT 84067
Phone (801) 779-3266

1491 E Ridgeline Dr
South Ogden, UT 84405
Phone (317) 790-7550

6112 S Harrison
South Ogden, UT 84405
Phone (801) 475-3800

5740 Crestwood Dr
South Ogden, UT 84405
Phone (801) 479-7771

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1093702003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3800",
            "fax_number": "801-475-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6112 S 1550 E",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844055007",
            "telephone_number": "801-475-3800",
            "fax_number": "801-475-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "GRACE",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "180186-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ogden, UT

Sources for this page

Verify at the official NPI Registry.