Individual provider Active NPI

Sean Stanley, M.D.

  • Emergency Medicine Physician
  • Brigham City, UT
National Provider Identifier
1295121473
Registry record updated Dec 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
10728269-1205 Issued in UT
Practice address
950 Medical Dr
Brigham City, UT 84302-4724
Phone
(435) 734-9471
NPI assigned
Apr 14, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 10728269-1205 UT Primary

Addresses

Primary practice location

950 Medical Dr
Brigham City, UT 84302-4724

Mailing address

950 Medical Dr
Brigham City, UT 84302-4724
Phone (435) 734-9471

Other practice location 1

6071 W Outer Dr
Detroit, MI 48235-2624
Phone (313) 966-1020

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
I20180628002720 UT Practitioner - Emergency Medicine 4981905551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

950 S 500
Brigham City, UT 84302-4724
Phone (435) 734-9471

Hospital & facility affiliations

  • Brigham City Community Hospital Hospital, Brigham City, UT, CCN 460017
  • Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005
  • Cache Valley Hospital Hospital, North Logan, UT, CCN 460054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10728269-1205UTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Integrated Care, LLC Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients

Locations

1600 W Antelope Dr
Layton, UT 84041
Phone (801) 807-1000

630 Medical Dr
North Salt Lake, UT 84010
Phone (801) 292-6231

2690 N 600 W
Pleasant View, UT 84414
Phone (801) 786-7911

3451 W 5600 S
Roy, UT 84067
Phone (801) 896-5600

333 N 300 W
Salt Lake City, UT 84103
Phone (801) 463-7415

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

2055 N Main St
Tooele, UT 84074
Phone (435) 843-3600

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 964-3111

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545436800000",
    "number": "1295121473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 MEDICAL DR",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843024724",
            "telephone_number": "435-734-9471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 MEDICAL DR",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843024724",
            "telephone_number": "435-734-9471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6071 W Outer Dr",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482352624",
            "country_code": "US",
            "telephone_number": "313-966-1020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "SEAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2018-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "10728269-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brigham City, UT

Sources for this page

Verify at the official NPI Registry.