Individual provider Active NPI

Bryant Lewis Peterson, CRNA

  • Certified Registered Nurse Anesthetist
  • Salt Lake City, UT
National Provider Identifier
1174794127
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
5252922-4406 Issued in UT
Practice address
8TH Ave C Street
Salt Lake City, UT 84143-0001
Phone
(801) 408-3350
Fax
(770) 701-6675
NPI assigned
Mar 18, 2008
Last updated
Oct 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RNA-717 ID
Certified Registered Nurse Anesthetist 367500000X 5252922-4406 UT Primary
Registered Nurse 163W00000X N37726 ID

Addresses

Primary practice location

8TH Ave C Street
Salt Lake City, UT 84143-0001

Mailing address

PO Box 3570
Salt Lake City, UT 84110-3570
Phone (801) 432-2600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bpeterson253620@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170427001001 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547349615 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Anesthesia Associates LLCGroup PAC ID 3274590856, 17 clinicians
Central Utah Anesthesia LCGroup PAC ID 0547160152, 3 clinicians

Practice addresses (Care Compare)

630 Medical Dr
Bountiful, UT 84010-4908
Phone (801) 299-2160

640 W 800
Orem, UT 84057-3658
Phone (801) 356-6002

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
89.3
Improvement activities
40
Cost
78.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
N37726IDMDRegistered Nurse
RNA-717IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
Western Anesthesia Associates LLC Anesthesiology CurrentSince Feb 6, 2025 Accepting new patients
University of Utah Adult Services CurrentSince Aug 2, 2017 Accepting new patients
NPH Anesthesia of Utah, LLC Anesthesiology CurrentSince Oct 1, 2021 Accepting new patients
Central Utah Anesthesia LC Anesthesiology CurrentSince Jul 21, 2025 Accepting new patients
University of Utah Adult Services CurrentSince Aug 2, 2017 Accepting new patients
Brigham Anesthesia, LLC Anesthesiology CurrentSince Apr 1, 2017 Accepting new patients

Locations

2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450

630 Medical Dr
North Salt Lake, UT 84010
Phone (801) 292-6231

640 W 800 N
Orem, UT 84057
Phone (801) 356-6002

560 W 465 N
Ste 604
Providence, UT 84332
Phone (435) 753-1600

1067 N 500 W
Provo, UT 84604
Phone (801) 356-6002

8th Ave C St E
Salt Lake City, UT 84143
Phone (218) 929-0674

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Interoperability endpoints

  • Direct secure messaging: bpeterson253620@direct.med.utah.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1174794127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3570",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103570",
            "telephone_number": "801-432-2600",
            "fax_number": "770-701-6675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8TH AVE C STREET",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841430001",
            "telephone_number": "801-408-3350",
            "fax_number": "770-701-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BRYANT",
        "middle_name": "LEWIS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-18",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA-717",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "5252922-4406",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "N37726",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bpeterson253620@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.