Individual provider Active NPI

Anthony Richard Groathouse, MD

  • Emergency Medicine Physician
  • West Jordan, UT
National Provider Identifier
1710900568
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
921886051205 Issued in UT
Practice address
2655 W 9000 S
West Jordan, UT 84088-8542
Phone
(801) 256-6399
NPI assigned
Jul 25, 2006
Last updated
Oct 18, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 921886051205 UT Primary

Addresses

Primary practice location

2655 W 9000 S
West Jordan, UT 84088-8542

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 256-6399

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
I20050420000494 UT Practitioner - Family Practice 3779521729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Utah School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

2655 W 9000
West Jordan, UT 84088-8542
Phone (801) 256-6399

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
921886051205UTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Mar 1, 2005 Accepting new patients
Ihc Health Services Inc CurrentSince Mar 1, 2005 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

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

280 N Main St
N Salt Lake, UT 84010
Phone (801) 270-4400

9493 S 700 E
Sandy, UT 84070
Phone (801) 270-4400

2000 S 900 E
Slc, UT 84105
Phone (801) 446-7786

3934 S 2300 E
Slc, UT 84124
Phone (801) 270-4400

11444 S Redwood Rd
South Jordan, UT 84095
Phone (801) 253-5900

2655 W 9000 S
West Jordan, UT 84088
Phone (801) 256-6343

3845 W 4700 S
West Valley City, UT 84129
Phone (801) 840-2020

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.

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1710900568",
    "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": "801-256-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840888542",
            "telephone_number": "801-256-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROATHOUSE",
        "first_name": "ANTHONY",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "921886051205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

Verify at the official NPI Registry.