Individual provider Active NPI

Bart R Preston, CRNA

  • Certified Registered Nurse Anesthetist
  • Salt Lake City, UT
National Provider Identifier
1598861304
Registry record updated Sep 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
200347-4406 Issued in UT
Practice address
1954 Fort Union Blvd Ste 114
Salt Lake City, UT 84121-6899
Phone
(800) 594-5736
NPI assigned
Sep 16, 2006
Last updated
Sep 24, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 200347-4406 UT Primary

Addresses

Primary practice location

1954 Fort Union Blvd Ste 114
Salt Lake City, UT 84121-6899

Mailing address

1954 Fort Union Blvd Ste 114
Salt Lake City, UT 84121-6899
Phone (800) 594-5736

Other identifiers 7

IdentifierTypeStateIssuer
QM0000054865OtherUTALTIUS
660761OtherUTDESERET MUTUAL
107008987102OtherUTIHC
PRA05806OtherUTMOLINA
02003474401001OtherUTBCBS
5581OtherUTHEALTHY U
66114OtherUTPEHP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041026000971 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173584737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NPH Anesthesia of Utah LLCGroup PAC ID 9537584313, 91 clinicians

Practice addresses (Care Compare)

5475 S 500
Ogden, UT 84405-6905
Phone (469) 998-7443

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
200347-4406UTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
NPH Anesthesia of Utah, LLC CurrentSince Nov 1, 2021 Accepting new patients

Locations

2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450

170 N 1100 E
American Fork, UT 84003
Phone (801) 714-6570

331 N 400 W
Orem, UT 84057
Phone (801) 224-4080

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

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

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.

Hospital & facility affiliations 2

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190592000000",
    "number": "1598861304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1954 FORT UNION BLVD STE 114",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216899",
            "telephone_number": "800-594-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1954 FORT UNION BLVD STE 114",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216899",
            "telephone_number": "800-594-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "BART",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "200347-4406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "QM0000054865",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL",
            "identifier": "660761",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC",
            "identifier": "107008987102",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "PRA05806",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02003474401001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY U",
            "identifier": "5581",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "66114",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.