Active NPI
Brett S. Wallin, M.D
- Internal Medicine Physician
- St George, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 7984164-1205
- Practice address
- 1380 E Medical Center Dr
St George, UT 84790-2123 - Phone
- (435) 251-2992
- NPI assigned
- Jun 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 7984164-1205 | UT | Primary |
| Internal Medicine Physician | 207R00000X | 81245 | AZ | |
| Internal Medicine Physician | 207R00000X | 01068450A | IN |
Addresses
Primary practice location
1380 E Medical Center Dr
St George, UT 84790-2123
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other practice location 1
368 E Riverside Dr Ste 3B
Saint George, UT 84790-7068
Phone (435) 656-3324
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201004220 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1380 E Medical Ctr Dr
St George, UT 84790-2123
Phone (435) 251-2740
Hospital & facility affiliations
- St. George Regional Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81245 | AZ | MD | Internal Medicine Physician |
| 01068450A | IN | MD | Internal Medicine Physician |
| 7984164-1205 | UT | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Family Medicine | Current | Accepting new patients |
| Choctaw Nation of Oklahoma | Current | Accepting new patients | |
| Choctaw Nation of Oklahoma | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Choctaw Nation of Oklahoma | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Past | Accepting new patients | |
| Desert Pain Specialists, LLC | Past | Accepting new patients |
Locations
1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981
1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204
410 N M St
Hugo, OK 74743
Phone (580) 326-7561
902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600
1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026
109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100
2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200
1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440
205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992
3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810
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.
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
- Family Medicine Physician
- Cedar City, UT
- NPI 1922132828
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
- Primary Care Clinic/Center
- Durant, OK
- NPI 1396173449
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Broken Bow, OK
- NPI 1447143532
-
- Pain Medicine (Anesthesiology) Physician
- Saint George, UT
- NPI 1871762450
-
- General Acute Care Hospital
- St George, UT
- NPI 1366452880
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- St George, UT
- NPI 1366452880
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748822400000",
"number": "1457557613",
"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",
"fax_number": "435-656-3325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1380 E MEDICAL CENTER DR",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847902123",
"telephone_number": "435-251-2992"
}
],
"practiceLocations": [
{
"address_1": "368 E Riverside Dr Ste 3B",
"address_purpose": "LOCATION",
"city": "Saint George",
"state": "UT",
"postal_code": "847907068",
"country_code": "US",
"telephone_number": "435-656-3324",
"fax_number": "435-656-3325",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALLIN",
"first_name": "BRETT",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-25",
"last_updated": "2025-06-02",
"certification_date": "2025-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "UT",
"license": "7984164-1205",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "81245",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01068450A",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201004220",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.