Individual provider Active NPI

Bryson S. Smith, M.D.

  • Neurological Surgery Physician
  • Ogden, UT
National Provider Identifier
1669507984
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
262635-1205 Issued in UT
Practice address
4403 Harrison Blvd.
Suite 1815
Ogden, UT 84403-3339
Phone
(801) 732-5930
Fax
(801) 732-5988
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 262635-1205 UT
Neurological Surgery Physician 207T00000X 262635-1205 UT Primary

Addresses

Primary practice location

4403 Harrison Blvd.
Suite 1815
Ogden, UT 84403-3339

Mailing address

4403 Harrison Blvd.
Suite 1815
Ogden, UT 84403-3339
Phone (801) 732-5900

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
I20071012000180 UT Practitioner - Neurosurgery 9234225848 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
262635-1205UTMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Ogden Clinic PC Neurological Surgery CurrentSince Oct 1, 2019 Accepting new patients
Ogden Clinic Specialty Services LLC Neurological Surgery CurrentSince Jan 1, 2021 Accepting new patients

Locations

1916 N 700 W
Ste 200
Layton, UT 84041

1916 N 700 W
Ste 250
Layton, UT 84041
Phone (801) 479-0312

4650 Harrison Blvd
Ogden, UT 84403
Phone (801) 475-3481

4403 Harrison Blvd
Ste 1815
Ogden, UT 84403
Phone (801) 387-6520

4403 Harrison Blvd
Ste 181
Ogden, UT 84403

5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1669507984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD.",
            "address_2": "SUITE 1815",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033339",
            "telephone_number": "801-732-5900",
            "fax_number": "801-732-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD.",
            "address_2": "SUITE 1815",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033339",
            "telephone_number": "801-732-5930",
            "fax_number": "801-732-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRYSON",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "262635-1205",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "UT",
            "license": "262635-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.