Active NPI
Montana Wynn Gubrud, PA-S
- Physician Assistant
- Murray, UT
National Provider Identifier
1609404409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 14289197-1206
- Practice address
- 5911 S Fashion Blvd Ste 200
Murray, UT 84107-7210 - Phone
- (385) 525-3270
- NPI assigned
- Mar 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 14289197-1206 | UT | Primary |
Addresses
Primary practice location
5911 S Fashion Blvd Ste 200
Murray, UT 84107-7210
Mailing address
5911 S Fashion Blvd Ste 200
Murray, UT 84107-7210
Phone (385) 525-3270
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utah Valley University | Past | Accepting new patients |
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 and National Provider Directory roles.
-
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787011200000",
"number": "1609404409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5911 S FASHION BLVD STE 200",
"city": "MURRAY",
"state": "UT",
"postal_code": "841077210",
"telephone_number": "385-525-3270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5911 S FASHION BLVD STE 200",
"city": "MURRAY",
"state": "UT",
"postal_code": "841077210",
"telephone_number": "385-525-3270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUBRUD",
"first_name": "MONTANA",
"middle_name": "WYNN",
"credential": "PA-S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-29",
"last_updated": "2026-08-18",
"certification_date": "2026-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "14289197-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.