Ian Taylor Sudbury, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

5018 W Great Basin Cir
Herriman, UT 84096-1846

Phone

(801) 699-8660

NPI assigned

Aug 9, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science, Physician Assistant

Practice roles

Locations

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.

• Highland Medical PLLC

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1215010327
  Medicare reassignment
• Interventional Spine & Pain Management

  • Pain Medicine (Anesthesiology) Physician
  • Murray, UT
  • NPI 1609204338
  Medicare reassignment
• Interventional Spine & Pain Management

  • Pain Medicine Physician
  • Ogden, UT
  • NPI 1992342414
  NPD

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1316620131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5018 W GREAT BASIN CIR",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840961846",
            "telephone_number": "801-699-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5018 W GREAT BASIN CIR",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840961846",
            "telephone_number": "801-699-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDBURY",
        "first_name": "IAN",
        "middle_name": "TAYLOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruno Strafacci, ACMHC
• Robert Joseph Strasser
• Kirsten Brooke Stratton
• Sarah Stroup
• Michael Sturgell
• Maria Trinidad Sulbaran, R.D.M.S
• Kimberly C Summers, DPT
• Summit Mohs Dermatology PLLC
• Sundance Canyon Academy
• Sundance Canyon Academy

• Physician Assistant in Herriman, UT
• Providers in Herriman, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.