Active NPI
Erin Bagley Oberg, PA-C
- Physician Assistant
- North Logan, UT
National Provider Identifier
1124309711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA1529
- Practice address
- Rocky Mountain Dermatology 1760 N 200 E
#101
North Logan, UT 84341 - Phone
- (435) 787-0560
- NPI assigned
- Sep 8, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA1529 | ME | Primary |
Addresses
Primary practice location
Rocky Mountain Dermatology 1760 N 200 E
#101
North Logan, UT 84341
Mailing address
1760 N 200 E
#101
North Logan, UT 84341
Phone (435) 787-0560
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230830002245 | UT | Practitioner - Physician Assistant | 8820260995 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1760 N 200
Suite 101
North Logan, UT 84341-1202
Phone (435) 787-0560
1760 N 200 E
Suite 101
Logan, UT 84341-1202
434 E 5350
Suite D
Ogden, UT 84405-5417
Phone (801) 827-9100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4905 | AZ | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David J Barth P.C. | Past | Accepting new patients | |
| Pa4Free LLC | Past | Accepting new patients |
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.
-
- Surgical Physician Assistant
- Las Vegas, NV
- NPI 1104162643
-
- Surgical Physician Assistant
- Las Vegas, NV
- NPI 1700123759
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681257600000",
"number": "1124309711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1760 N 200 E",
"address_2": "#101",
"city": "NORTH LOGAN",
"state": "UT",
"postal_code": "84341",
"telephone_number": "435-787-0560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ROCKY MOUNTAIN DERMATOLOGY 1760 N 200 E",
"address_2": "#101",
"city": "NORTH LOGAN",
"state": "UT",
"postal_code": "84341",
"telephone_number": "435-787-0560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBERG",
"first_name": "ERIN",
"middle_name": "BAGLEY",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-08",
"last_updated": "2023-04-12",
"certification_date": "2023-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ME",
"license": "PA1529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.