Individual provider Active NPI

Gregg J Stephany, PA-C

  • Surgical Physician Assistant
  • Murray, UT
National Provider Identifier
1487747515
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
6717503-1206 Issued in UT
Practice address
5848 S Fashion Blvd Ste 120
Murray, UT 84107-6157
Phone
(801) 314-4900
Fax
(801) 314-4919
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 6717503-1206 UT Primary
Physician Assistant 363A00000X 1003 CO

Addresses

Primary practice location

5848 S Fashion Blvd Ste 120
Murray, UT 84107-6157

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other identifiers 1

IdentifierTypeStateIssuer
07010036MedicaidCO

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071019000109 UT Practitioner - Physician Assistant 0345259057 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services Inc 3,948 clinicians
The Orthopedic Clinic LC 18 clinicians

Practice addresses (Care Compare)

325 8TH Ave
Salt Lake City, UT 84143-0001
Phone (801) 408-3617

5848 S Fashion Blvd
Suite 110
Salt Lake City, UT 84107-6175
Phone (801) 314-4188

5848 S Fashion Blvd
The Orthopedic Specialty Hosp Physicans Gro
Murray, UT 84107-6121
Phone (801) 314-4100

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

8 TH Ave and C St
Salt Lake City, UT 84143-0001
Phone (801) 408-1100

Hospital & facility affiliations

  • LDS Hospital Hospital, Salt Lake City, UT, CCN 460006
  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010
  • Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1003COMDPhysician Assistant
6717503-1206UTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Oct 1, 2007 Accepting new patients
Ihc Health Services Inc CurrentSince May 1, 2019 Accepting new patients
Ihc Health Service Inc Orthopaedic Surgery CurrentSince Oct 1, 2007 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

5848 S Fashion Blvd
Ste 120
Salt Lake City, UT 84107
Phone (801) 314-4100

5848 S Fashion Blvd
Salt Lake Cty, UT 84107
Phone (801) 314-4040

5848 S Fashion Blvd
Ste 110
Salt Lake Cty, UT 84107
Phone (801) 314-4188

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

324 Tenth Ave
#163
Salt Lake Cty, UT 84103

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

Organizations & group practices 7

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 3

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1487747515",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5848 S FASHION BLVD STE 120",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076157",
            "telephone_number": "801-314-4900",
            "fax_number": "801-314-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHANY",
        "first_name": "GREGG",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "UT",
            "license": "6717503-1206",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1003",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07010036",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.