Individual provider Active NPI

Robert John Bunnell, M.D.

  • Internal Medicine Physician
  • Ogden, UT
National Provider Identifier
1659494680
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
6068447-1205 Issued in UT
Practice address
4401 Harrison Blvd
Ogden, UT 84403-3195
Phone
(801) 389-7483
NPI assigned
Apr 6, 2007
Last updated
Oct 22, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 6068447-1205 UT Primary

Addresses

Primary practice location

4401 Harrison Blvd
Ogden, UT 84403-3195

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 389-7483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070730000634 UT Practitioner - Internal Medicine 2365543766 Reassigns benefits to 2 organizations
I20200506001446 NY Practitioner - Internal Medicine 2365543766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Utah School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

4401 Harrison Blvd
Ogden, UT 84403-3195
Phone (801) 387-2800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6068447-1205UTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jul 1, 2007 Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Ihc Health Services Inc CurrentSince Jul 1, 2007 Accepting new patients
Ihc Health Services Inc Internal Medicine Current Accepting new patients
Ihc Health Services Inc CurrentSince Oct 2, 2018 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Manhasset, NY 11030

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

4401 Harrison Blvd
South Ogden, UT 84403
Phone (801) 387-2800

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Organizations & group practices 6

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 1

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1659494680",
    "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",
            "telephone_number": "801-389-7483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033195",
            "telephone_number": "801-389-7483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNNELL",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "6068447-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.