NPIMap

Organization Active NPI

Green River Radiology, P.C.

  • Diagnostic Radiology Physician
  • Pleasant Grove, UT
National Provider Identifier
1508533878
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
GREEN RIVER RADIOLOGY, P.C.
Practice address
1982 W Pleasant Grove Blvd Ste L
Pleasant Grove, UT 84062-3268
Phone
(801) 563-0333
Fax
(801) 563-0335
NPI assigned
Aug 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Authorized official

Name
Ramona Ahern
Title
Special Assistant Secretary
Phone
(952) 738-4441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1982 W Pleasant Grove Blvd Ste L
Pleasant Grove, UT 84062-3268

Mailing address

5775 Wayzata Blvd Ste 400
Saint Louis Park, MN 55416-1271
Phone (866) 674-7933

Other practice location 1

3702 S State Street
Suite 111
Salt Lake City, UT 84115-5078
Phone (801) 869-5630

Other names 1

  • RAYUS Radiology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211027002062 UT Part B Supplier - Clinic/Group Practice 5294123063 Receives reassigned benefits from 57 practitioners
Practice locations: Layton, UT; Pleasant Grove, UT; Riverton, UT; Salt Lake City, UT; South Ogden, UT; Springville, UT; Taylorsville, UT
O20251210000488 IA Part B Supplier - Clinic/Group Practice 5294123063 Receives reassigned benefits from 1 practitioner
Practice locations: Iowa City, IA

National Provider Directory

National Provider Directory

Locations

729 King St
Ste 100
Layton, UT 84041
Phone (801) 563-0333

12842 S 3600 W
Ste 100
Riverton, UT 84065
Phone (385) 253-4586

556 S 1750 W
Springville, UT 84663
Phone (385) 398-7900

Practitioners 56

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1508533878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 400",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554161271",
            "telephone_number": "866-674-7933",
            "fax_number": "952-513-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1982 W PLEASANT GROVE BLVD STE L",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840623268",
            "telephone_number": "801-563-0333",
            "fax_number": "801-563-0335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3702 S State Street",
            "address_2": "Suite 111",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841155078",
            "country_code": "US",
            "telephone_number": "801-869-5630",
            "fax_number": "801-869-5649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GREEN RIVER RADIOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "AHERN",
        "authorized_official_first_name": "RAMONA",
        "authorized_official_title_or_position": "SPECIAL ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "952-738-4441"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAYUS Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pleasant Grove, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.