Gary Vaughan Halversen, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

5176697-1205 Issued in UT

Practice address

1034 N 500 W
Provo, UT 84604-3380

Phone

(801) 225-6246

Fax

(801) 225-1525

NPI assigned

Feb 1, 2006

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

Medicare fee-for-service enrollment

Enrolled in UT

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 1

Specialty

Diagnostic Radiology

Education

George Washington University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services Inc 3,948 clinicians

Utah Valley Radiology Associates Inc 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001
• American Fork Hospital Hospital, American Fork, UT, CCN 460023
• San Juan Hospital Hospital, Monticello, UT, CCN 461308
• Intermountain Health Spanish Fork Hospital Hospital, Spanish Fork, UT, CCN 460062
• Park City Hospital Hospital, Park City, UT, CCN 460057

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15493/brand/1/csg/1/fhir/r4

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.

• Utah Valley Radiology Associates Inc

  • Diagnostic Radiology Physician
  • Provo, UT
  • NPI 1265483598

  UT

  Medicare reassignment Care Compare group
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880

  UT

  Medicare reassignment NPD
• St. George Radiology Inc.

  • Diagnostic Radiology Physician
  • St George, UT
  • NPI 1790736130

  Diagnostic Radiology, UT

  Medicare reassignment NPD
• Bakorp, L.L.C.

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • West Valley, UT
  • NPI 1023357894
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Mt Pleasant, UT
  • NPI 1679510218
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Tellica Imaging, LLC

  • Physiological Laboratory
  • Ogden, UT
  • NPI 1144802802
  NPD
• Ihc Health Services Inc

  • Diagnostic Radiology Physician
  • Provo, UT
  • NPI 1003291568

  Diagnostic Radiology

  NPD (past)
• Riverwoods Urgent Care Center LC

  • Emergency Medicine Physician
  • Provo, UT
  • NPI 1801894035
  NPD (past)
• Ubmc Anesthesiology

  • Certified Registered Nurse Anesthetist
  • Roosevelt, UT
  • NPI 1043643877
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services Inc

  • General Acute Care Hospital
  • Park City, UT
  • NPI 1851530984

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Provo, UT
  • NPI 1114025491

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Spanish Fork, UT
  • NPI 1124661384

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • Infusion Therapy Clinic/Center
  • Spanish Fork, UT
  • NPI 1679426944

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • American Fork, UT
  • NPI 1912014358

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • Infusion Therapy Clinic/Center
  • American Fork, UT
  • NPI 1982557252

  Hospital

  Care Compare affiliation
• San Juan County Hospital

  • Critical Access Hospital
  • Monticello, UT
  • NPI 1942251459

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1487625869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560W 800 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840573746",
            "telephone_number": "801-225-6424",
            "fax_number": "801-225-1525"
        },
        {
            "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": "801-225-6246",
            "fax_number": "801-225-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVERSEN",
        "first_name": "GARY",
        "middle_name": "VAUGHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "5176697-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Brooke Hall, NP
• Natalie Brooke Hall, MD
• Rebecca Hall
• Brittany M. Halliday, SSW
• Heidi Halls, CSW
• Lyman L Hamblin, LCSW
• Janeen Hamel
• Alexis Rachel Hamilton, LCSW
• Christopher A. Hamilton, MD
• Ellen Hamilton

• All providers in Provo, UT
• Diagnostic Radiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; 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.

Verify at the official NPI Registry.