Individual provider Active NPI

Michael S. Chamberlain, MD

  • Neurology Physician
  • Ogden, UT
National Provider Identifier
1649859257
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
12994411-1205 Issued in UT
Practice address
4403 Harrison Blvd Ste 2815
Ogden, UT 84403-3326
Phone
(801) 387-7880
NPI assigned
Apr 2, 2021
Last updated
Aug 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 12994411-1205 UT Primary

Addresses

Primary practice location

4403 Harrison Blvd Ste 2815
Ogden, UT 84403-3326

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

175 N Medical Drive East
Salt Lake City, UT 84132-0001
Phone (801) 585-5405

Other practice location 2

1 Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2317

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally
Direct Messaging Address mchamberlain301172@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20250714002449 UT Practitioner - Neurology 0547661993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Utah School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 585-6387

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Jun 1, 2025 Accepting new patients
University of Utah Adult Services CurrentSince Jun 1, 2025 Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients

Locations

175 N Medical Dr
Slc, UT 84112
Phone (801) 581-6908

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: mchamberlain301172@direct.med.utah.edu

Organizations & group practices 4

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 3

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": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1649859257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 2815",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033326",
            "telephone_number": "801-387-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 N Medical Drive East",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841320001",
            "country_code": "US",
            "telephone_number": "801-585-5405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271570001",
            "country_code": "US",
            "telephone_number": "336-716-2317",
            "fax_number": "336-716-2810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "UT",
            "license": "12994411-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mchamberlain301172@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.