Individual provider Active NPI

Alton Riley Pugh, CRNA

  • Certified Registered Nurse Anesthetist
  • Blanding, UT
National Provider Identifier
1477885994
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
5133328-4406 Issued in UT
Practice address
802 S 200 W
Blanding, UT 84511
Phone
(435) 678-3993
Fax
(435) 678-3992
NPI assigned
Feb 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X COA11321 OH
Certified Registered Nurse Anesthetist 367500000X 5133328-4406 UT Primary

Addresses

Primary practice location

802 S 200 W
Blanding, UT 84511

Mailing address

802 S 200 W
Blanding, UT 84511-3910
Phone (435) 678-3993

Other practice location 1

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-4380

Other practice location 2

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-4380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120813000341 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446386023 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Mountain HospitalGroup PAC ID 0749344661, 9 clinicians

Practice addresses (Care Compare)

802 S 200
Blanding, UT 84511-3910
Phone (435) 678-3993

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
COA11321OHMDCertified Registered Nurse Anesthetist
5133328-4406UTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Navajo Health System, Incorporated CurrentSince Jul 12, 2012 Accepting new patients
Blue Mountain Hospital CurrentSince Sep 30, 2020 Accepting new patients
Utah Navajo Health System, Incorporated Past Accepting new patients
Anesthesiology Services Network LTD Past Accepting new patients
Utah Navajo Health System, Incorporated Past Accepting new patients

Locations

802 S 200 W
Blanding, UT 84511
Phone (435) 678-3869

802 S 200 W
Ste A
Blanding, UT 84511
Phone (435) 678-3993

Interoperability endpoints

  • Direct secure messaging: alton.pugh.1@16299.direct.athenahealth.com
  • Direct secure messaging: alton.pugh.1@16098.direct.athenahealth.com

Organizations & group practices 5

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": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1477885994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 S 200 W",
            "city": "BLANDING",
            "state": "UT",
            "postal_code": "845113910",
            "telephone_number": "435-678-3993",
            "fax_number": "435-678-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 S 200 W",
            "city": "BLANDING",
            "state": "UT",
            "postal_code": "84511",
            "telephone_number": "435-678-3993",
            "fax_number": "435-678-3992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Wyoming St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092722",
            "country_code": "US",
            "telephone_number": "937-208-4380",
            "fax_number": "937-208-3843",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Wyoming St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092722",
            "country_code": "US",
            "telephone_number": "937-208-4380",
            "fax_number": "937-208-3843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUGH",
        "first_name": "ALTON",
        "middle_name": "RILEY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-09",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA11321",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "5133328-4406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blanding, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.