Individual provider Active NPI

Brett S. Wallin, M.D

  • Internal Medicine Physician
  • St George, UT
National Provider Identifier
1457557613
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7984164-1205 Issued in UT
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

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
201004220MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121011000752 UT Practitioner - Internal Medicine 9032303409 Reassigns benefits to 1 organization
I20180206000927 TX Practitioner - Internal Medicine 9032303409 Reassigns benefits to 1 organization

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

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 Hospital, St George, UT, CCN 460021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
81245AZMDInternal Medicine Physician
01068450AINMDInternal Medicine Physician
7984164-1205UTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Family Medicine CurrentSince Feb 5, 2020 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Jan 15, 2018 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Jan 15, 2018 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Feb 5, 2020 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.

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": "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

Verify at the official NPI Registry.