NPIMap

Organization Active NPI

Ashley Valley Physician Practice LLC

Doing business as Ghanshyam P Massand, MD

  • Orthopaedic Surgery Physician
  • Vernal, UT
National Provider Identifier
1255568564
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
6150961-1205 Issued in UT
Legal business name
ASHLEY VALLEY PHYSICIAN PRACTICE LLC
Doing business as
Ghanshyam P Massand, MD
Practice address
175 N 100 W
Suite 204
Vernal, UT 84078-2049
Phone
(435) 789-1522
Fax
(435) 789-1524
NPI assigned
Jun 12, 2009
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 6150961-1205 UT Primary

Addresses

Primary practice location

175 N 100 W
Suite 204
Vernal, UT 84078-2049

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000

Other identifiers 1

IdentifierTypeStateIssuer
1740245604MedicaidUT

Other names 1

  • Ghanshyam P Massand, MD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050119001166 UT Part B Supplier - Clinic/Group Practice 4284683947 Receives reassigned benefits from 57 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vernal, UT; Roosevelt, UT; Price, UT

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

150 W 100 N
Vernal, UT 84078
Phone (435) 789-3342

175 N 100 W
Ste 204
Vernal, UT 84078
Phone (435) 789-1522

175 N 100 W
Ste 205
Vernal, UT 84078
Phone (435) 781-6300

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1255568564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 N 100 W",
            "address_2": "SUITE 204",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840782049",
            "telephone_number": "435-789-1522",
            "fax_number": "435-789-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLEY VALLEY PHYSICIAN PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-12",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "UT",
            "license": "6150961-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740245604",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ghanshyam P Massand, MD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ghanshyam P Massand, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vernal, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.