Individual provider Active NPI

Scott F Hansen, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • SLC, UT
National Provider Identifier
1235212192
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
1608301205 Issued in UT
Practice address
324 10TH Ave
Suite 100
SLC, UT 84103-2853
Phone
(801) 408-8700
Fax
(801) 408-8732
NPI assigned
Oct 23, 2006
Last updated
Jun 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 1608301205 UT Primary

Addresses

Primary practice location

324 10TH Ave
Suite 100
SLC, UT 84103-2853

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 408-8700

Other identifiers 1

IdentifierTypeStateIssuer
942854057012MedicaidUT

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050917000516 UT Practitioner - Internal MedicinePractitioner - Emergency Medicine 1557394665 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1608301205UTMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Nov 1, 2006 Accepting new patients
Ihc Health Services Inc CurrentSince Nov 1, 2006 Accepting new patients
Ihc Health Services Inc CurrentSince Aug 1, 2012 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

425 Medical Dr
#220
Bountiful, UT 84010
Phone (801) 292-7288

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

900 Round Valley Dr
Park City, UT 84060
Phone (435) 658-7000

54 N 8th W
Salt Lake City, UT 84116
Phone (801) 359-0901

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417

324 Tenth Ave
Ste 100
Slc, UT 84103
Phone (801) 408-5735

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

3930 W Parkway Blvd
West Valley City, UT 84120
Phone (435) 462-2441

Organizations & group practices 5

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1235212192",
    "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": "801-408-8700",
            "fax_number": "801-408-8732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 10TH AVE",
            "address_2": "SUITE 100",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841032853",
            "telephone_number": "801-408-8700",
            "fax_number": "801-408-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "SCOTT",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "UT",
            "license": "1608301205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "942854057012",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in SLC, UT

Sources for this page

Verify at the official NPI Registry.