Individual provider Active NPI

Baron Harrell

  • Family Nurse Practitioner
  • Ogden, UT
National Provider Identifier
1518610641
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10376632-4405 Issued in UT
Practice address
5475 S 500 E
Ogden, UT 84405-6905
Phone
(801) 479-2111
NPI assigned
Jan 29, 2022
Last updated
Jun 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10376632-4405 UT Primary
Family Medicine Physician 207Q00000X 10376632-4405 UT

Addresses

Primary practice location

5475 S 500 E
Ogden, UT 84405-6905

Mailing address

1806 N 400 W
North Ogden, UT 84414-7292
Phone (801) 388-0832

Other practice location 1

1600 W Antelope Dr
Layton, UT 84041-1142
Phone (801) 807-1000

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
I20220721000621 UT Practitioner - Nurse Practitioner 1153702279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1600 W Antelope Dr
Layton, UT 84041-1142
Phone (801) 807-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Integrated Care, LLC CurrentSince Mar 31, 2022 Accepting new patients

Locations

1600 W Antelope Dr
Layton, UT 84041
Phone (801) 807-1000

2690 N 600 W
Pleasant View, UT 84414
Phone (801) 786-7911

3451 W 5600 S
Roy, UT 84067
Phone (801) 896-5600

333 N 300 W
Salt Lake City, UT 84103
Phone (801) 463-7415

5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1643414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1518610641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 N 400 W",
            "city": "NORTH OGDEN",
            "state": "UT",
            "postal_code": "844147292",
            "telephone_number": "801-388-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5475 S 500 E",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056905",
            "telephone_number": "801-479-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 W Antelope Dr",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840411142",
            "country_code": "US",
            "telephone_number": "801-807-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "BARON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-29",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "10376632-4405",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "10376632-4405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.