NPIMap

Individual provider Active NPI

Christopher Gerald Wilkerson, M.D.

  • Neurological Surgery Physician
  • Murray, UT
National Provider Identifier
1629481015
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
10105775-1205 Issued in UT
Practice address
5171 S Cottonwood St
Ste 950
Murray, UT 84107-5713
Phone
(801) 507-9555
Fax
(801) 507-9550
NPI assigned
Jun 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 10105775-1205 UT Primary

Addresses

Primary practice location

5171 S Cottonwood St
Ste 950
Murray, UT 84107-5713

Mailing address

5171 S Cottonwood St Ste 950
Murray, UT 84107-5713
Phone (801) 507-9555

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clinical@nsamd.directgreeenway.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220825001457 UT Practitioner - Neurosurgery 4981983459 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians
Neurosurgical Associates LLCGroup PAC ID 4587578224, 11 clinicians

Practice addresses (Care Compare)

5121 S Cottonwood St
Murray, UT 84107-5701
Phone (801) 507-7000

5171 S Cottonwood St
Suite 950
Murray, UT 84107-5713
Phone (801) 507-9555

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion199
Laminectomy or laminotomy (partial removal of spine bones)38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10105775-1205UTMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosurgical Associates LLC Neurological Surgery CurrentSince Jun 25, 2022 Accepting new patients
Ihc Health Services Inc CurrentSince Jul 1, 2022 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Ihc Health Services Inc Neurological Surgery Past Accepting new patients

Locations

900 Round Valley Dr
Ste 100
Park City, UT 84060
Phone (435) 655-6600

5171 S Cottonwood St
Ste 950
Salt Lake City, UT 84107
Phone (801) 507-9555

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1629481015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 S COTTONWOOD ST STE 950",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075713",
            "telephone_number": "801-507-9555",
            "fax_number": "801-507-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5171 S COTTONWOOD ST",
            "address_2": "STE 950",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075713",
            "telephone_number": "801-507-9555",
            "fax_number": "801-507-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "GERALD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-03",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "UT",
            "license": "10105775-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clinical@nsamd.directgreeenway.com",
            "affiliation": "N",
            "endpointDescription": "Direct address to EMR software",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5171 S Cottonwood St Ste 950",
            "city": "Murray",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841075713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.