Active NPI
Layne A Hermansen, DO
- Family Medicine Physician
- Draper, UT
National Provider Identifier
1245315332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 58316971204
- Practice address
- 877 E 12300 S
Suite 201
Draper, UT 84020 - Phone
- (801) 542-7111
- Fax
- (801) 542-7112
- NPI assigned
- Oct 26, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 58316971204 | UT | Primary |
Addresses
Primary practice location
877 E 12300 S
Suite 201
Draper, UT 84020
Mailing address
877 E 12300 S
Suite 201
Draper, UT 84020
Phone (801) 542-7111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58316971204 | UT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Strains & Pains Clinic | Past | Accepting new patients | |
| My Family Doctor LLC | Family Medicine | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Medicine & Rehabilitation Physician
- Draper, UT
- NPI 1952630832
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245315332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "877 E 12300 S",
"address_2": "SUITE 201",
"city": "DRAPER",
"state": "UT",
"postal_code": "84020",
"telephone_number": "801-542-7111",
"fax_number": "801-542-7112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "877 E 12300 S",
"address_2": "SUITE 201",
"city": "DRAPER",
"state": "UT",
"postal_code": "84020",
"telephone_number": "801-542-7111",
"fax_number": "801-542-7112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMANSEN",
"first_name": "LAYNE",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "UT",
"license": "58316971204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.