S Dwayne Roberts MD LLC

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

2764891205 Issued in UT

Legal business name

S DWAYNE ROBERTS MD LLC

Practice address

1050 E South Temple
3Rd Floor
Salt Lake City, UT 84102-1507

Phone

(801) 505-5223

NPI assigned

Aug 25, 2008

Organization subpart

No

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

Authorized official

Name

Angela S Boyle

Title

Business Manager

Phone

(623) 206-9238

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward James Kimball, MD

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1699865204
  NPD (past)

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231804800000",
    "number": "1194972836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 N 1100 W",
            "city": "PLEASANT VIEW",
            "state": "UT",
            "postal_code": "844141336",
            "telephone_number": "623-206-9238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E SOUTH TEMPLE",
            "address_2": "3RD FLOOR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021507",
            "telephone_number": "801-505-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S DWAYNE ROBERTS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-25",
        "last_updated": "2009-01-13",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "623-206-9238"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "UT",
            "license": "2764891205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David K Ryser, MD
• Ralph W. Ryser, D.M.D.
• Randall J Ryser, M.D.
• Audra Rysevas
• Darin T. Ryujin, PA
• S-H Opco Salt Lake City, LLC
• S-H Opco Salt Lake City, LLC
• S-H Opco Salt Lake City, LLC
• Shauna Sa'U, LPN
• Kathryn Mae Saad

• Emergency Medical Services (Emergency Medicine) Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.