Ryan K Anderson D P M P C
Organization Active NPI Foot & Ankle Surgery Podiatrist · Bountiful, UT
NPI 1639200215 · NPPES record last updated Dec 31, 2025
Key facts
- NPI
- 1639200215
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- Legal business name
- RYAN K ANDERSON D P M P C
- Practice address
- 596 W 750 S Ste 200
Bountiful, UT 84010-7281 - Phone
- (206) 703-2204
- Fax
- (801) 397-1938
- NPI assigned
- Mar 8, 2007
- Organization subpart
- No
Authorized official
- Name
- Ryan K Anderson, DPM
- Title
- Sole Owner
- Phone
- (206) 703-2204
Other NPIs with the same Medicare PAC ID 1
Practitioners 99
-
Derek Scott Anselmo, DPM
-
Treg Corbridge, DPM
-
Aaron Eugene Frodsham, M.D.
-
Christopher Funk, DPM
-
Nan E Hodge, D.P.M.
-
Shawn Dale Isaeff, M.D.
-
Clark C Larsen, DPM
-
William Woodrow Martin, D.P.M
-
Niari Anne McFarland, NURSE PRACTITIONER
-
David George McKenzie II, D.P.M.
-
David S Mehr, MD
-
Sara C Mleso, FNP
-
Amber Dawn Peterson, FNP-C
-
Riley Joseph Rampton, DPM
-
Bryan L Seagle, D.P.M.
-
Ryan Westbroek, FNP
-
Julien Adicho, DPM
-
Harsh Amin, DPM
-
Cole Barton, DPM
-
Benjamin Heber Bauer, D.P.M.
-
Amy K Bodart, DPM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (6 enrollments) in UT, NM, OR, NV, TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050903000007 | UT | Part B Supplier - Clinic/Group Practice | 7517999121 |
Receives reassigned benefits from 39 practitioners Practice locations: West Valley, UT; West Jordan, UT; Tooele, UT; Logan, UT; South Ogden, UT; Sandy, UT; Salt Lake City, UT; Murray, UT… |
| O20100930048796 | UT | DME Supplier - Physician - Podiatry | 7517999121 | Practice locations: Bountiful, UT |
| O20160629000276 | NM | Part B Supplier - Clinic/Group Practice | 7517999121 |
Receives reassigned benefits from 26 practitioners Practice locations: Rio Rancho, NM; Santa Fe, NM; Gallup, NM; Taos, NM; Los Alamos, NM; Los Lunas, NM; Albuquerque, NM; Las Vegas, NM… |
| O20230605001910 | OR | Part B Supplier - Clinic/Group Practice | 7517999121 |
Receives reassigned benefits from 2 practitioners Practice locations: Eugene, OR |
| O20240328000987 | NV | Part B Supplier - Clinic/Group Practice | 7517999121 |
Receives reassigned benefits from 3 practitioners Practice locations: Las Vegas, NV |
| O20240724000926 | TX | Part B Supplier - Clinic/Group Practice | 7517999121 |
Receives reassigned benefits from 5 practitioners Practice locations: El Paso, TX |
National Provider Directory
Locations
650 J St
Ste 405
Lincoln, NE 68508
Phone (801) 815-6500
8008 Menaul Blvd NE
Albuquerque, NM 87110
Phone (206) 703-2204
1300 Wyoming Blvd NE
Albuquerque, NM 87112
Phone (505) 298-7666
700 Lomas Blvd NE
Bldg 1
Albuquerque, NM 87102
Phone (505) 843-6464
3908 Carlisle Blvd NE
Albuquerque, NM 87107
Phone (505) 639-5916
511 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 225-7091
1608 7th St
Ste B
Las Vegas, NM 87701
Phone (505) 355-2766
3917 West Rd
Ste 156
Los Alamos, NM 87544
Phone (505) 365-1503
1650 Hospital Dr
Santa Fe, NM 87505
Phone (505) 660-0743
1618 N Lee Trevino Dr
Ste D
El Paso, TX 79936
Phone (206) 703-2204
1225 E Cliff Dr
Ste 2A
El Paso, TX 79902
Phone (915) 533-1622
1225 E Cliff Dr
Ste 2
El Paso, TX 79902
425 Medical Dr
#209
Bountiful, UT 84010
Phone (801) 292-4425
1551 Renaissance Towne Dr
Ste 370
Bountiful, UT 84010
Phone (801) 292-4425
596 W 750 S
Ste 105
Bountiful, UT 84010
Phone (801) 292-4425
903 S Main St
Ste B
Brigham City, UT 84302
380 S Main St
Centerville, UT 84014
Phone (530) 869-1444
3130 S Highland Dr
#B4
Millcreek, UT 84106
2721 N Highway 89
Pleasant View, UT 84404
Phone (801) 292-4425
3590 W 9000 S
Ste 215
West Jordan, UT 84088
Phone (801) 566-7297
1561 W 7000 S
Ste 201
West Jordan, UT 84084
Phone (435) 671-4726
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Pathology/Laboratory Medicine Physician |
207ZP0105X | |||
| Vascular & Interventional Radiology Physician |
2085R0204X | |||
| Vascular Surgery Physician |
2086S0129X | |||
| Foot & Ankle Surgery Podiatrist |
213ES0103X | Yes | ||
| Radiologic Technologist |
247100000X | |||
| Clinical Medical Laboratory | 291U00000X |
Addresses
Primary practice location
596 W 750 S Ste 200
Bountiful, UT 84010-7281
Mailing address
434 W Ascension Way Ste 425
Murray, UT 84123-3102
Phone (206) 703-2204
Other practice location 1
3777 Pecos McLeod Ste 103
Las Vegas, NV 89121-4265
Phone (206) 703-2204
Other practice location 2
1060 Chambers St
Eugene, OR 97402-3745
Phone (206) 703-2204
Other practice location 3
8008 Menaul Blvd NE
Albuquerque, NM 87110-4608
Phone (206) 703-2204
Other practice location 4
1618 N Lee Trevino Dr Ste D
El Paso, TX 79936-5104
Phone (206) 703-2204
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 74619 | Other | UT | PEHP |
| 529471093001 | Medicaid | UT |
Other names
- Foot & Ankle Specialists of Utah
Other providers in Bountiful, UT
- Michelle Rusch
- Mia Rushton
- Russell B Shields MD PC
- Mary Melinda Russell-Stamp
- Milton Russon
- David Nathaniel Arthur Ryan
- Emilie Kara Ryan
- Jeffery M Sabey
- William Taylor Sadler
- Cali Saenz
All providers in Bountiful, UT · Foot & Ankle Surgery Podiatrist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.