Brian K. Penrose, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

13232441-0501 Issued in UT

Practice address

1350 N 500 E
Logan, UT 84341-2400

NPI assigned

Jun 3, 2016

Last updated

Jun 20, 2023By 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 3

Addresses

Other identifiers 7

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

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

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  dba Dixie MFM High Risk OB

  • Obstetrics & Gynecology Physician
  • St George, UT
  • NPI 1134428279
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services Inc

  dba Orem Community Hospital Physicians

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)
• Saint Joseph Regional Medical Center- Plymouth Campus Inc

  dba Saint Joseph Foot and Ankle Sports Medicine Institute Plymouth

  • Family Medicine Physician
  • Plymouth, IN
  • NPI 1538585187

  Foot & Ankle Surgery

  NPD (past)
• Saint Joseph Regional Medical Center, Inc.

  dba Saint Joseph Medical Group

  • Pulmonary Disease Physician
  • Plymouth, IN
  • NPI 1225082878
  NPD (past)

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

• Ihc Health Services Inc

  dba Intermountain Health Logan Regional Hospital

  • General Acute Care Hospital
  • Logan, UT
  • NPI 1831108497
  Care Compare affiliation

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1437508116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 N 500 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412400",
            "telephone_number": "435-716-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 N 500 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENROSE",
        "first_name": "BRIAN",
        "middle_name": "K.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-03",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07001313A",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "UT",
            "license": "13232441-0501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201375910",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "738460022",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000001293859",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTAH MEDICAL LICENSE",
            "identifier": "13232441-0501",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000001366840",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN MEDICAL LICENSE",
            "identifier": "41000341A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IN1933075",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Curtis C Pedersen, DPM
• Peery Family Dentistry
• Samuel Lee Peery, D.M.D.
• McKell Peidl
• Faith Pennington
• Jacob Penrose, DPT, CWS
• Keely Marie Perkes, MA, CCC-SLP
• Lisa Perkins
• Mark Perkins
• Rilee Diane Perrett, LCSW

• Foot & Ankle Surgery Podiatrist in Logan, UT
• Providers in Logan, UT by specialty
• Foot & Ankle Surgery Podiatrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.