Individual provider Active NPI

Brandon Bargeloh

  • Computed Tomography Radiologic Technologist
  • Salt Lake City, UT
National Provider Identifier
1407438104
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Computed Tomography Radiologic TechnologistTaxonomy code 2471C3401X
License
506506
Practice address
500 Foothill Dr
Salt Lake City, UT 84148-0001
Phone
(801) 582-1565
NPI assigned
Apr 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Computed Tomography Radiologic Technologist 2471C3401X 506506 Primary

Addresses

Primary practice location

500 Foothill Dr
Salt Lake City, UT 84148-0001

Mailing address

1530 Kenny Rd
Columbus, OH 43212-2563
Phone (740) 706-6942

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

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1407438104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 KENNY RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432122563",
            "telephone_number": "740-706-6942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FOOTHILL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841480001",
            "telephone_number": "801-582-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARGELOH",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3401X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Computed Tomography",
            "state": null,
            "license": "506506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.