NPIMap

Individual provider Active NPI

Nathan Phelps, MD

  • Family Medicine Physician
  • Ogden, UT
National Provider Identifier
1255628996
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9140789-1205 Issued in UT
Practice address
4650 Harrison Blvd
Ogden, UT 84403-4303
Phone
(801) 475-3021
Fax
(801) 475-3031
NPI assigned
Jul 1, 2011
Last updated
Jan 17, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9140789-1205 UT Primary

Addresses

Primary practice location

4650 Harrison Blvd
Ogden, UT 84403-4303

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141110002596 UT Practitioner - Family Practice 2466690367 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joshua Oaks MD PLLCGroup PAC ID 0840776688, 31 clinicians

Practice addresses (Care Compare)

520 Medical Dr
Suite 300
Bountiful, UT 84010-8925
Phone (801) 292-1422

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ogden Clinic Specialty Services LLC Current Accepting new patients
Joshua Oaks MD PLLC Family Medicine CurrentSince Jan 1, 2026 Accepting new patients
Ogden Clinic PC Family Medicine CurrentSince Nov 1, 2014 Accepting new patients

Locations

520 Medical Dr
Ste 300
Bountiful, UT 84010
Phone (801) 292-1422

763 N Redwood Rd
Ste 110
North Salt Lake, UT 84054
Phone (801) 292-1423

4650 Harrison Blvd
Ogden, UT 84403
Phone (801) 475-3481

5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100

Networks

  • UT PPO D-SNP
  • UT PPO

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA
  • Direct secure messaging: nathan.phelps.1@16218.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Elevation HospiceDraper, UT, CCN 461609 Hospice Contracted Managing Employee Dec 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1255628996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3021",
            "fax_number": "801-475-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844034303",
            "telephone_number": "801-475-3021",
            "fax_number": "801-475-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "NATHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9140789-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.