Active NPI
Bryant Lewis Peterson, CRNA
- Certified Registered Nurse Anesthetist
- Salt Lake City, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 5252922-4406
- 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, 2022
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
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
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 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| N37726 | ID | MD | Registered Nurse |
| RNA-717 | ID | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Adult Services | Current | Accepting new patients | |
| Western Anesthesia Associates LLC | Anesthesiology | Current | Accepting new patients |
| University of Utah Adult Services | Current | Accepting new patients | |
| NPH Anesthesia of Utah, LLC | Anesthesiology | Current | Accepting new patients |
| Central Utah Anesthesia LC | Anesthesiology | Current | Accepting new patients |
| University of Utah Adult Services | Current | Accepting new patients | |
| Brigham Anesthesia, LLC | Anesthesiology | Current | 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
- 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.
-
- Anesthesiology Physician
- Provo, UT
- NPI 1578765533
-
- Anesthesiology Physician
- Bountiful, UT
- NPI 1174566277
-
- Anesthesiology Physician
- Brigham City, UT
- NPI 1710904800
-
- Anesthesiology Physician
- Ogden, UT
- NPI 1366077273
-
- General Practice Physician
- Salt Lake City, UT
- NPI 1114321981
-
dba University of Utah Rehabilitation & Wellness Program
- Physical Medicine & Rehabilitation Physician
- Salt Lake City, UT
- NPI 1275937146
-
dba University of Utah Hospital Radiology Department
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1598169419
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.