Active NPI
Parker Richard Roberts
- Certified Registered Nurse Anesthetist
- Ogden, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 103974474406
- Practice address
- 5475 S 500 E
Ogden, UT 84405-6905 - Phone
- (800) 880-3566
- Fax
- (801) 432-2670
- NPI assigned
- Dec 2, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 10397447-3102 | UT | |
| Certified Registered Nurse Anesthetist | 367500000X | 103974474406 | UT | Primary |
Addresses
Primary practice location
5475 S 500 E
Ogden, UT 84405-6905
Mailing address
2221 Lakeside Blvd Ste 600
Richardson, TX 75082-4416
Phone (469) 505-1652
Other practice location 1
5782 Adams Ave Pkwy
Ogden, UT 84405-6947
Phone (800) 880-3566
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- University of Utah School of Medicine
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5475 S 500
Ogden, UT 84405-6905
Phone (469) 998-7443
Hospital & facility affiliations
- Ogden Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10397447-3102 | UT | MD | Registered Nurse |
| 103974474406 | UT | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NPH Anesthesia of Utah, LLC | Current | Accepting new patients |
Locations
2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450
5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111
3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Ogden, UT
- NPI 1366077273
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Ogden, UT
- NPI 1720031636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671753600000",
"number": "1679283360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2221 LAKESIDE BLVD STE 600",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750824416",
"telephone_number": "469-505-1652",
"fax_number": "469-436-3976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5475 S 500 E",
"city": "OGDEN",
"state": "UT",
"postal_code": "844056905",
"telephone_number": "800-880-3566",
"fax_number": "801-432-2670"
}
],
"practiceLocations": [
{
"address_1": "5782 Adams Ave Pkwy",
"address_purpose": "LOCATION",
"city": "Ogden",
"state": "UT",
"postal_code": "844056947",
"country_code": "US",
"telephone_number": "800-880-3566",
"fax_number": "801-432-2670",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBERTS",
"first_name": "PARKER",
"middle_name": "RICHARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-02",
"last_updated": "2022-12-23",
"certification_date": "2022-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "UT",
"license": "10397447-3102",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "UT",
"license": "103974474406",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.