Zachary D. Van Wagoner, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

9651138-1205 Issued in UT

Practice address

1000 E 15 S
Ste 350
Payson, UT 84651-3246

Phone

(801) 465-5602

Fax

(801) 465-4480

NPI assigned

Mar 22, 2011

Last updated

Apr 21, 2026By the provider in NPPES

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

Electronic endpoints 1

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

Specialty

General Surgery

Education

Ohio State University College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Layton Hospital Hospital, Layton, UT, CCN 460061
• Holy Cross Hospital-Davis Hospital, Layton, UT, CCN 460041

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: zachary.vanwagoner.p1@direct.tannerclinic.nextgenshare.com

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.

• Tanner Memorial Clinic

  • Internal Medicine Physician
  • Layton, UT
  • NPI 1447239355

  Surgery

  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group
• Tanner Memorial Clinic

  dba Tanner Clinic Layton South

  • Multi-Specialty Clinic/Center
  • Layton, UT
  • NPI 1538951165
  NPD
• Utah Weight Loss, LLC

  • Dietary Manager
  • Provo, UT
  • NPI 1720447766
  NPD (past)

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

• Catholic Health Initiatives Colorado

  dba Holy Cross Hospital - Davis

  • General Acute Care Hospital
  • Layton, UT
  • NPI 1346945839
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health Layton Hospital

  • General Acute Care Hospital
  • Layton, UT
  • NPI 1417460205
  Care Compare affiliation

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1346549912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 15 S",
            "address_2": "STE 350",
            "city": "PAYSON",
            "state": "UT",
            "postal_code": "846513246",
            "telephone_number": "801-465-5602",
            "fax_number": "801-465-4480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 N Main St",
            "address_purpose": "LOCATION",
            "city": "Kaysville",
            "state": "UT",
            "postal_code": "840371194",
            "country_code": "US",
            "telephone_number": "801-498-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 W Layton Pkwy Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840413692",
            "country_code": "US",
            "telephone_number": "801-543-8705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN WAGONER",
        "first_name": "ZACHARY",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-22",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "9651138-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC/ Office Ally",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Utah Idea Builder LLC (Extreme Motus)
• Valley Obstetrics and Gynecology, P.C. (South Valley OB/GYN, P.C.)
• Lisa Van de Water, CSW
• Michael Hampton Van Dyke, D.C.
• Miranda Lee Van Horn, LCSW
• Vision Experts Inc. (Knighton Vision)
• Karl K Vizmeg, M.D.
• Wal-Mart Stores, Inc (Vision Center 30-5167)
• Walgreen Co (Rite Aid)
• Walgreen Co (Walgreens #13011)

• Surgery Physician in Payson, UT
• Providers in Payson, UT by specialty
• Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.