Individual provider Active NPI

Greg E Halliday, PA-C

  • Physician Assistant
  • Logan, UT
National Provider Identifier
1366431918
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3086482-1206 Issued in UT
Practice address
1300 N 500 E Ste 320
Logan, UT 84341-2462
Phone
(801) 373-4366
Fax
(801) 429-8191
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3086482-1206 UT Primary

Addresses

Primary practice location

1300 N 500 E Ste 320
Logan, UT 84341-2462

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 354-8225

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC/Office Ally

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070718000088 UT Practitioner - Physician Assistant 6204875602 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

1034 N 500
Provo, UT 84604-3380
Phone (801) 373-4366

1055 N 500
Provo, UT 84604-3305

1300 N 500
Suite 320
Logan, UT 84341-2462
Phone (801) 507-3513

1300 N 500 E
320 Imed HRS Logan
Logan, UT 84341-2462
Phone (435) 755-8200

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

  • Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3144AZMDUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
3086482-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jan 1, 2015 Accepting new patients
Revere Health PC CurrentSince Jul 1, 2008 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 1, 2015 Accepting new patients
Ihc Health Services Inc CurrentSince Sep 8, 2025 Accepting new patients
Revere Health PC CurrentSince Jul 1, 2008 Accepting new patients
Snow Canyon Clinic, Inc. PastSince Sep 1, 2005 Accepting new patients

Locations

110 W 1325 N
Ste 200
Cedar City, UT 84721
Phone (435) 586-7676

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

1300 N 500 E
Ste 320
North Logan, UT 84341
Phone (435) 716-2200

1055 N 500 W
Ste 101
Provo, UT 84604

475 W 940 N
Provo, UT 84604
Phone (801) 357-7909

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

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

1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479

Organizations & group practices 8

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 1

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": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1366431918",
    "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",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 500 E STE 320",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412462",
            "telephone_number": "801-373-4366",
            "fax_number": "801-429-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIDAY",
        "first_name": "GREG",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "3086482-1206",
            "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",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "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": []
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.