Brian T Norman, PA C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

9557601-1206 Issued in TX

Practice address

12523 S Creek Meadow Rd Ste 109
Riverton, UT 84065-7299

Phone

(801) 251-0735

Fax

(512) 583-1099

NPI assigned

Jun 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2026 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Ageless Men'S Health, LLC

  • Clinical Medical Laboratory
  • Memphis, TN
  • NPI 1003098997
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1235173543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 E 32ND ST",
            "address_2": "SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787052707",
            "telephone_number": "512-476-2830",
            "fax_number": "512-583-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12523 S CREEK MEADOW RD STE 109",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657299",
            "telephone_number": "801-251-0735",
            "fax_number": "512-583-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORMAN",
        "first_name": "BRIAN",
        "middle_name": "T",
        "credential": "PA C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "9557601-1206",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "9557601-1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AND WELLNESS",
            "identifier": "9557601-1206",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PA04216",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Nichols
• Cicely Irene Nickerson
• Clare Nicolas, AUD
• Ying Ning, MD
• Bong K Noh, DDS
• Siona Tutau Nuusila
• Rachel Kristina Nytch
• Teresa Oldham
• Jennifer Christine Oleskowicz, RN, APRN
• Brady D Olsen, LCSW

• Surgical Physician Assistant in Riverton, UT
• Providers in Riverton, UT by specialty
• Surgical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.