Stephan L Ralston, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

1648361205 Issued in UT

Practice address

1452 E Ridgeline Dr
Suite 100
South Ogden, UT 84405-4946

Phone

(801) 479-5937

Fax

(801) 479-5917

NPI assigned

Dec 1, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1538237375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1452 E RIDGELINE DR",
            "address_2": "SUITE 100",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844054946",
            "telephone_number": "801-479-5937",
            "fax_number": "801-479-5917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1452 E RIDGELINE DR",
            "address_2": "SUITE 100",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844054946",
            "telephone_number": "801-479-5937",
            "fax_number": "801-479-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALSTON",
        "first_name": "STEPHAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "UT",
            "license": "1648361205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Prince, BCSI, LMP
• Private Healthcare Facilities
• Provas of Ogden, LLC
• Wesley Pullen, CSW, LMSW
• Stephanie Kara Quinn, CSW
• Rochelle Rasmussen
• Flint Read
• Cora Ann Reedy, CMHC
• Jennifer Reese, BCBA
• Jean Rodriguez Reyes, REGISTERED BEHAVIOR

• Plastic Surgery Physician in South Ogden, UT
• Providers in South Ogden, UT by specialty
• Plastic Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.