Gary R Sanderson, D.O.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

6949058-1204 Issued in UT

Practice address

1034 N 500 W
Provo, UT 84604-3380

Phone

(801) 373-7850

NPI assigned

Jul 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, UT, CO, CA, NV5 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 5

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gary.sanderson.1@13794.direct.athenahealth.com

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.

• Central Valley Medical Center

  • Critical Access Hospital
  • Nephi, UT
  • NPI 1881658110
  Medicare reassignment NPD
• Central Valley Medical Center

  • Family Medicine Physician
  • Nephi, UT
  • NPI 1992724975
  Medicare reassignment NPD
• Emergency Physicians Integrated Care, LLC

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1578598199
  Medicare reassignment NPD
• Utah Valley Emergency Physicians Inc

  • Emergency Medicine Physician
  • Provo, UT
  • NPI 1649204553
  Medicare reassignment NPD
• West Emergency Services, LLC

  • Emergency Medicine Physician
  • Price, UT
  • NPI 1548929565
  Medicare reassignment NPD
• Emergency Physicians Southwest, PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1912053752
  Medicare reassignment NPD
• Emergency Professionals of Colorado, PC

  • Emergency Medicine Physician
  • Loveland, CO
  • NPI 1396496469
  Medicare reassignment NPD
• Quantum Healthcare Medical Associates of Arizona, PC

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1821391269

  AZ

  Medicare reassignment NPD
• Sierra ER Department Physicians Medical Group Inc.

  • Emergency Medicine Physician
  • Susanville, CA
  • NPI 1033570247
  Medicare reassignment NPD
• Team Physicians of Nevada-Scherr, P.C.

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1073942116

  NV

  Medicare reassignment NPD
• Emergency Professionals of Colorado, PC

  • Emergency Medicine Physician
  • Greeley, CO
  • NPI 1366835415
  NPD
• Emergency Professionals of Colorado, PC

  • Emergency Medicine Physician
  • Greeley, CO
  • NPI 1306421201
  NPD (past)

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1467651232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 N 700 E",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840622448",
            "telephone_number": "801-785-5785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043380",
            "telephone_number": "801-373-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "GARY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "4645",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "UT",
            "license": "6949058-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Gilbert Sandberg, PH.D.
• Aaron William Sanders, DO
• Alissa Sanders
• Matthew D. Sanders
• Thomas Briggs Sanders, M.D.
• Joanne Sandoval
• Reynie Thomas Sandoval, LCSW
• David Rubin Sandweiss, MD
• Caleb Sanford
• Carl Barry Sanford, M.A., CMHC

• Emergency Medical Services (Emergency Medicine) Physician in Provo, UT
• Providers in Provo, UT by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.