Individual provider Active NPI

Robert L Langston, CRNA

  • Certified Registered Nurse Anesthetist
  • West Valley City, UT
National Provider Identifier
1366557407
Registry record updated Jul 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
212994-4406 Issued in UT
Practice address
3460 Pioneer Pkwy
West Valley City, UT 84120-2049
Phone
(801) 993-9526
Fax
(801) 733-5872
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 212994-4406 UT Primary

Addresses

Primary practice location

3460 Pioneer Pkwy
West Valley City, UT 84120-2049

Mailing address

65 W 850 S
Centerville, UT 84014-2198
Phone (801) 733-2155

Other identifiers 11

IdentifierTypeStateIssuer
24053OtherUTPEHP
PR00660OtherUTMOLINA
004373400MedicaidID
117819900MedicaidWY
350411OtherUTDESERET MUTUAL
53000OtherUTHEALTHY U
870532396LA1OtherUTEDUCATORS MUTUAL
190400800OtherUTUS DEPT OF LABOR
QM0000023694OtherUTALTIUS
2000012OtherUTUNITED HEALTHCARE
200611540AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040825001199 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193799096 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
212994-4406UTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
NPH Anesthesia of Utah, LLC CurrentSince May 1, 2021 Accepting new patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients

Locations

2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450

96 E Kimballs Ln
Ste 100
Draper, UT 84020
Phone (801) 233-9300

3000 N Triumph Blvd
Lehi, UT 84043
Phone (385) 345-3000

1820 Sidewinder Dr
Park City, UT 84060
Phone (435) 647-9100

65 S Mario Capecchi Dr
Salt Lake City, UT 84132
Phone (801) 581-2352

5450 S Green St
#B
Salt Lake City, UT 84123
Phone (801) 290-6060

6322 S 3000 E
Ste 170
Salt Lake Cty, UT 84121
Phone (801) 513-3223

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Organizations & group practices 4

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248134400000",
    "number": "1366557407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 W 850 S",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840142198",
            "telephone_number": "801-733-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 PIONEER PKWY",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841202049",
            "telephone_number": "801-993-9526",
            "fax_number": "801-733-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGSTON",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2009-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "212994-4406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "24053",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "PR00660",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004373400",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117819900",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL",
            "identifier": "350411",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY U",
            "identifier": "53000",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATORS MUTUAL",
            "identifier": "870532396LA1",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "190400800",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "QM0000023694",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2000012",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200611540A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.