Individual provider Active NPI

Christine A Cheng, MD

  • Plastic Surgery Physician
  • Bountiful, UT
National Provider Identifier
1306848338
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
95-294457-1205 Issued in UT
Practice address
415 Medical Dr
Suite D102
Bountiful, UT 84010-4946
Phone
(801) 298-9774
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 95-294457-1205 UT Primary

Addresses

Primary practice location

415 Medical Dr
Suite D102
Bountiful, UT 84010-4946

Mailing address

415 Medical Dr
Ste D102
Bountiful, UT 84010-8906
Phone (801) 593-9223

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
I20050419000998 UT Practitioner - Plastic and Reconstructive Surgery 4183662315 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

415 Medical Dr
Suite C101
Bountiful, UT 84010-8901
Phone (801) 298-9774

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy12
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95-294457-1205UTMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Aug 29, 2010 Accepting new patients
Christine a. Cheng MD PC Plastic Surgery CurrentSince Feb 10, 2020 Accepting new patients
Ihc Health Services, Inc. CurrentSince Aug 29, 2010 Accepting new patients
Ihc Health Services Inc Surgery Current Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

415 Medical Dr
Ste D102
Bountiful, UT 84010
Phone (801) 298-9774

415 Medical Dr
Ste C101
Bountiful, UT 84010
Phone (801) 298-9774

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

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1306848338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR",
            "address_2": "STE D102",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108906",
            "telephone_number": "801-593-9223",
            "fax_number": "801-593-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR",
            "address_2": "SUITE D102",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104946",
            "telephone_number": "801-298-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENG",
        "first_name": "CHRISTINE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "UT",
            "license": "95-294457-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.