Active NPI
Dalton H Wright, MD
- Diagnostic Radiology Physician
- Provo, UT
National Provider Identifier
1174569131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 174359-1205
- Practice address
- 1055 N 500 W
Suite 112
Provo, UT 84604-3305 - Phone
- (801) 812-4624
- Fax
- (801) 812-4699
- NPI assigned
- Jun 20, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 174359-1205 | UT | Primary |
Addresses
Primary practice location
1055 N 500 W
Suite 112
Provo, UT 84604-3305
Mailing address
1055 N 500 W
Credentialing Department
Provo, UT 84604-3305
Phone (801) 354-8225
Other practice location 1
555 W Sr 164
Salem, UT 84653
Phone (801) 812-4624
Other practice location 2
1490 E Foremaster Dr Bldg C
St George, UT 84790-4550
Phone (801) 812-4624
Other practice location 3
3000 N Triumph Blvd Ste 100
Lehi, UT 84043-4999
Phone (385) 345-3155
Other practice location 4
1175 E 50 S Ste 141
American Fork, UT 84003-2845
Phone (801) 492-5996
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 219637 | Other | UT | ALTIUS |
| P00132863 | Other | PALMETTO GBA | |
| 79184 | Other | UT | PEHP |
| 870281028000 | Medicaid | UT | |
| 107007673103 | Other | UT | IHC |
| 16-00694 | Other | UT | UNITED HEALTHCARE |
Electronic endpoints 5
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | medreview@reverehealth.com | Revere Health PC | |
| Direct Messaging Address | medreview@reverehealth.com | Revere Health PC | |
| Direct Messaging Address | medreview@reverehealth.com | Revere Health PC | |
| Direct Messaging Address | medreview@reverehealth.com | Revere Health PC | |
| Direct Messaging Address | medreview@reverehealth.com | Revere Health PC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 174359-1205 | UT | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1174569131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 N 500 W",
"address_2": "CREDENTIALING DEPARTMENT",
"city": "PROVO",
"state": "UT",
"postal_code": "846043305",
"telephone_number": "801-354-8225",
"fax_number": "801-418-0941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 N 500 W",
"address_2": "SUITE 112",
"city": "PROVO",
"state": "UT",
"postal_code": "846043305",
"telephone_number": "801-812-4624",
"fax_number": "801-812-4699"
}
],
"practiceLocations": [
{
"address_1": "555 W SR 164",
"address_purpose": "LOCATION",
"city": "Salem",
"state": "UT",
"postal_code": "84653",
"country_code": "US",
"telephone_number": "801-812-4624",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1490 E Foremaster Dr Bldg C",
"address_purpose": "LOCATION",
"city": "St George",
"state": "UT",
"postal_code": "847904550",
"country_code": "US",
"telephone_number": "801-812-4624",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3000 N Triumph Blvd Ste 100",
"address_purpose": "LOCATION",
"city": "Lehi",
"state": "UT",
"postal_code": "840434999",
"country_code": "US",
"telephone_number": "385-345-3155",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1175 E 50 S Ste 141",
"address_purpose": "LOCATION",
"city": "American Fork",
"state": "UT",
"postal_code": "840032845",
"country_code": "US",
"telephone_number": "801-492-5996",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WRIGHT",
"first_name": "DALTON",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2023-11-27",
"certification_date": "2020-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "UT",
"license": "174359-1205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS",
"identifier": "219637",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA",
"identifier": "P00132863",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEHP",
"identifier": "79184",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "870281028000",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHC",
"identifier": "107007673103",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "16-00694",
"state": "UT"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "medreview@reverehealth.com",
"affiliation": "Y",
"affiliationName": "Revere Health PC",
"address_1": "1175 E 50 S Ste 141",
"city": "American Fork",
"state": "UT",
"country_code": "US",
"postal_code": "840032845",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "medreview@reverehealth.com",
"affiliation": "Y",
"affiliationName": "Revere Health PC",
"address_1": "555 W SR 164",
"city": "Salem",
"state": "UT",
"country_code": "US",
"postal_code": "84653",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "medreview@reverehealth.com",
"affiliation": "Y",
"affiliationName": "Revere Health PC",
"address_1": "1490 E Foremaster Dr Bldg C",
"city": "St George",
"state": "UT",
"country_code": "US",
"postal_code": "847904550",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "medreview@reverehealth.com",
"affiliation": "Y",
"affiliationName": "Revere Health PC",
"address_1": "3000 N Triumph Blvd Ste 100",
"city": "Lehi",
"state": "UT",
"country_code": "US",
"postal_code": "840434999",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "medreview@reverehealth.com",
"affiliation": "Y",
"affiliationName": "Revere Health PC",
"address_1": "1490 E Foremaster Dr Bldg C",
"city": "St George",
"state": "UT",
"country_code": "US",
"postal_code": "847904550",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.