Individual provider Active NPI

Nathan C McBride, PA C

  • Physician Assistant
  • Ogden, UT
National Provider Identifier
1114915741
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2854591206 Issued in UT
Practice address
6028 S Ridgeline Dr
Ste 201
Ogden, UT 84405-6914
Phone
(801) 475-5400
Fax
(801) 475-8614
NPI assigned
Oct 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2854591206 UT Primary

Addresses

Primary practice location

6028 S Ridgeline Dr
Ste 201
Ogden, UT 84405-6914

Mailing address

PO Box 337
Layton, UT 84041-0337
Phone (801) 773-4840

Other identifiers 2

IdentifierTypeStateIssuer
87065316400ZMedicaidUT
107004880101OtherUTIHC

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
I20050209000982 UT Practitioner - Physician Assistant 9537110267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians

Practice addresses (Care Compare)

1477 N 2000
Suite C
Clinton, UT 84015-9099
Phone (801) 773-4840

1750 E 3100
Layton, UT 84040-2406
Phone (801) 773-4840

2038 W 1900
Syracuse, UT 84075-9320
Phone (801) 773-4840

2121 N 1700
Layton, UT 84041-8803
Phone (801) 773-4840

425 S 100
Layton, UT 84041-5356
Phone (801) 773-4840

6028 S Ridgeline Dr
Suite 201
Ogden, UT 84405-6908
Phone (801) 773-4840

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2854591206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Memorial Clinic CurrentSince Aug 17, 2020 Accepting new patients
Tanner Memorial Clinic CurrentSince Aug 17, 2020 Accepting new patients
Tanner Memorial Clinic Past Accepting new patients

Locations

6028 S Ridgeline Dr
Ste 201
South Ogden, UT 84405
Phone (801) 475-5400

Interoperability endpoints

  • Direct secure messaging: nathan.mcbride.p1@direct.tannerclinic.nextgenshare.com

Organizations & group practices 3

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 5

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": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1114915741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840410337",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6028 S RIDGELINE DR",
            "address_2": "STE 201",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056914",
            "telephone_number": "801-475-5400",
            "fax_number": "801-475-8614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "NATHAN",
        "middle_name": "C",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "2854591206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87065316400Z",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC",
            "identifier": "107004880101",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.