Isaac Micheal Ralphs, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12943421-8906 Issued in UT

Practice address

322 E Gateway Dr
Heber City, UT 84032-4610

Phone

(435) 654-1377

NPI assigned

Apr 14, 2021

Last updated

Jun 2, 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 1

Addresses

Other identifiers 1

Other names 1

• Ike Mike Ralphs Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Heiden Orthopedics,LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Park City, UT
  • NPI 1386896652
  NPD (past)

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1477133288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 E GATEWAY DR",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840324610",
            "telephone_number": "435-654-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 E GATEWAY DR",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840324610",
            "telephone_number": "435-654-1377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1681 W 3860 S Ste 103",
            "address_purpose": "LOCATION",
            "city": "West Valley City",
            "state": "UT",
            "postal_code": "841196274",
            "country_code": "US",
            "telephone_number": "801-997-0280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RALPHS",
        "first_name": "ISAAC",
        "middle_name": "MICHEAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-14",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12943421-8906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF UTAH DEPARTMENT OF COMMERCE, DIVISION OF OCCUPATIONAL & PROFESSIONAL LI",
            "identifier": "12943421-1206",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IKE",
            "last_name": "RALPHS",
            "middle_name": "MIKE",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Amber Pulley, LPN
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• Tawnya Lee Ray, WHNP-BC
• Megan Rieck
• Elizabeth Nichols Ritter, MD
• Marybeth F Robertson, SLP-CCC MS
• Rachel Elizabeth Robinson, PT, DPT

• Physician Assistant in Heber City, UT
• Providers in Heber City, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.