NPIMap

Individual provider Active NPI

Stanley Dwayne Roberts, MD

  • Sports Medicine (Family Medicine) Physician
  • Salem, UT
National Provider Identifier
1316993520
Registry record updated Sep 29, 2026
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(4) exclusion effective Oct 20, 2016.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
276489-1205 Issued in UT
Practice address
118 N Main St
Ste B
Salem, UT 84653-5698
Phone
(801) 477-9007
NPI assigned
May 26, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 276489 UT
Sports Medicine (Family Medicine) Physician 207QS0010X 276489-1205 UT Primary

Addresses

Primary practice location

118 N Main St
Ste B
Salem, UT 84653-5698

Mailing address

PO Box 10
Spanish Fork, UT 84660-0010
Phone (866) 898-7136

Other identifiers 6

IdentifierTypeStateIssuer
52892628603001OtherBCBS
174069OtherUTDESERET MUTUAL
87148OtherUTPEHP
D1423MedicaidUT
107018542102OtherUTSELECT HEALTH
P00221212OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
276489UTMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Timpanogos Emergency Physicians LLC Past Accepting new patients
William Preston MD, Inc Past Accepting new patients
Emergency Medical Billing LLC Past Accepting new patients
Emergency Medical Service, Inc Past Accepting new patients
Emergency Physicians Integrated Care, LLC Emergency Medical Services Past Accepting new patients
Premier Family Medical - City Center Past Accepting new patients
Utah Valley Emergency Physicians Inc PastSince Dec 15, 2019 Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1316993520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846600010",
            "telephone_number": "866-898-7136",
            "fax_number": "616-975-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 N MAIN ST",
            "address_2": "STE B",
            "city": "SALEM",
            "state": "UT",
            "postal_code": "846535698",
            "telephone_number": "801-477-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "STANLEY",
        "middle_name": "DWAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "UT",
            "license": "276489",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "UT",
            "license": "276489-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52892628603001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL",
            "identifier": "174069",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "87148",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D1423",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH",
            "identifier": "107018542102",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00221212",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, UT

Sources for this page

Verify at the official NPI Registry.