Individual provider Active NPI

Brad A Myers, MD

  • Surgery Physician
  • St George, UT
National Provider Identifier
1700986635
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
1845531205 Issued in UT
Practice address
1490 E Foremaster Dr Ste 200
St George, UT 84790-4496
Phone
(435) 628-1641
Fax
(435) 628-1660
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 1845531205 UT Primary

Addresses

Primary practice location

1490 E Foremaster Dr Ste 200
St George, UT 84790-4496

Mailing address

1490 E Foremaster Dr Ste 200
St George, UT 84790-4496
Phone (435) 628-1641

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
I20031222000464 UT Practitioner - General Surgery 6002711553 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1845531205UTMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Surgical Associates, Inc. CurrentSince Aug 1, 2013 Accepting new patients

Locations

3550 N University Ave
Ste 250
Provo, UT 84604
Phone (801) 374-9625

1490 E Foremaster Dr
Ste 200
St George, UT 84790
Phone (435) 528-1641

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1700986635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 E FOREMASTER DR STE 200",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904496",
            "telephone_number": "435-628-1641",
            "fax_number": "435-628-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 E FOREMASTER DR STE 200",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904496",
            "telephone_number": "435-628-1641",
            "fax_number": "435-628-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "BRAD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "1845531205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.