Individual provider Active NPI

Austin Edgar Brannon

  • Physician Assistant
  • Riverton, UT
National Provider Identifier
1215402631
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11835547-1206 Issued in UT
Practice address
3723 W 12600 S Ste 150
Riverton, UT 84065-7296
Phone
(801) 285-4560
NPI assigned
Oct 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11835547-1206 UT Primary

Addresses

Primary practice location

3723 W 12600 S Ste 150
Riverton, UT 84065-7296

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 243-1041

Other practice location 1

3451 S. 5600 W.
suite F
WVC, UT 84020
Phone (801) 957-0900

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211001002501 UT Practitioner - Physician Assistant 9830597087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
After Hours Medical LLCGroup PAC ID 8123926904, 30 clinicians

Practice addresses (Care Compare)

1126 E Draper Pkwy
Draper, UT 84020-9095
Phone (801) 545-0600

3451 S 5600
Suite F
Salt Lake City, UT 84120-1301
Phone (801) 957-0900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11835547-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
After Hours Medical LLC, Dba Medallus Medical CurrentSince Sep 25, 2021 Accepting new patients

Locations

1126 E Draper Pkwy
Draper, UT 84020
Phone (801) 545-0600

3451 S 5600 W
Ste F
West Valley City, UT 84120
Phone (801) 957-0900

Interoperability endpoints

  • Direct secure messaging: afterhoursmedical.austinbrannon@154036.advancedmd-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1215402631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-243-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3723 W 12600 S STE 150",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657296",
            "telephone_number": "801-285-4560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3451 S. 5600 W.",
            "address_2": "suite F",
            "address_purpose": "LOCATION",
            "city": "WVC",
            "state": "UT",
            "postal_code": "84020",
            "country_code": "US",
            "telephone_number": "801-957-0900",
            "fax_number": "801-966-4984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANNON",
        "first_name": "AUSTIN",
        "middle_name": "EDGAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-11",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "11835547-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

Verify at the official NPI Registry.