Individual provider Active NPI

Alexis C Ziebelman, MD

  • Family Medicine Physician
  • Midvale, UT
National Provider Identifier
1538864384
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14288195-1205 Issued in UT
Practice address
220 W 7200 S Ste a
Midvale, UT 84047-1053
Phone
(385) 261-2800
Fax
(877) 497-4661
NPI assigned
Apr 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14288195-1205 UT Primary

Addresses

Primary practice location

220 W 7200 S Ste a
Midvale, UT 84047-1053

Mailing address

1455 W 2200 S Ste 300
West Valley City, UT 84119-7219
Phone (385) 261-2800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250204000037 MT Order and Referring Only - Family PracticePractitioner - Family Practice 3971033192

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 299
Salt Lake City, UT 84110

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: aziebelman2605878@wm.providencedirect.org

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1538864384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 W 2200 S STE 300",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841197219",
            "telephone_number": "385-261-2800",
            "fax_number": "877-497-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W 7200 S STE A",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471053",
            "telephone_number": "385-261-2800",
            "fax_number": "877-497-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEBELMAN",
        "first_name": "ALEXIS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "14288195-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

Verify at the official NPI Registry.