NPIMap

Individual provider Active NPI

Keith Elliott, MD

  • Anesthesiology Physician
  • Salt Lake City, UT
National Provider Identifier
1508011180
Registry record updated Nov 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
7154775-1205 Issued in UT
Practice address
1552 South 1000 East
Salt Lake City, UT 84105
Phone
(801) 230-4125
NPI assigned
Nov 24, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 7154775-1205 UT Primary

Addresses

Primary practice location

1552 South 1000 East
Salt Lake City, UT 84105

Mailing address

1552 South 1000 East
Salt Lake City, UT 84105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120228000565 CO Practitioner - Anesthesiology 5597933911 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Loma Linda University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sterling Anesthesia Associates LLCGroup PAC ID 3971956434, 14 clinicians

Practice addresses (Care Compare)

1801 16TH St
Greeley, CO 80631-5154
Phone (970) 810-4121

615 Fairhurst St
Sterling, CO 80751-4523
Phone (970) 522-0122

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Colorado LLC Current Accepting new patients
Rocky Mountain State Anesthesia Providers Anesthesiology CurrentSince Mar 1, 2018 Accepting new patients
Banner Hospital Based Physicians Colorado LLC CurrentSince Apr 3, 2020 Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Apr 3, 2020 Accepting new patients
Banner Health Physicians Colorado LLC Current Accepting new patients
Rocky Mountain State Anesthesia Providers Anesthesiology CurrentSince Jul 18, 2017 Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Apr 3, 2020 Accepting new patients
Banner Hospital Based Physicians Colorado LLC CurrentSince Apr 3, 2020 Accepting new patients
Sterling Anesthesia Associates LLC Anesthesiology CurrentSince Jan 22, 2024 Accepting new patients

Locations

4700 Lady Moon Dr
Fort Collins, CO 80528
Phone (970) 521-4600

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

5890 W 13th St
Ste 102
Greeley, CO 80634
Phone (970) 348-0090

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

615 Fairhurst St
Sterling, CO 80751
Phone (970) 521-0322

Organizations & group practices 9

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 12

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": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227484800000",
    "number": "1508011180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1552 SOUTH 1000 EAST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 SOUTH 1000 EAST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84105",
            "telephone_number": "801-230-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-24",
        "last_updated": "2008-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "7154775-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.