Individual provider Active NPI

Brian Willard Loveridge, MD

  • Emergency Medicine Physician
  • Layton, UT
National Provider Identifier
1720080369
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
1205 Issued in UT
Practice address
2086 N 1700 W Ste D
Layton, UT 84041-1164
Phone
(385) 515-4100
Fax
(385) 351-1150
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 10269 NV
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 10269 NV
Emergency Medicine Physician 207P00000X 1205 UT Primary

Addresses

Primary practice location

2086 N 1700 W Ste D
Layton, UT 84041-1164

Mailing address

11511 Katy Fwy Ste 100
Houston, TX 77079-1902
Phone (281) 600-5000

Other practice location 1

3100 N Tenaya Way
Las Vegas, NV 89128-0436
Phone (702) 255-5025

Other identifiers 1

IdentifierTypeStateIssuer
002018840MedicaidNV

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
I20060321000054 UT Practitioner - Emergency Medicine 7618984311 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Utah School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2690 N 600
Pleasant View, UT 84414-7092
Phone (801) 786-7911

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1205UTMDEmergency Medicine Physician
10269NVMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes Relief Utah Ogden LLC CurrentSince Nov 8, 2017 Accepting new patients
Emergency Physicians Integrated Care, LLC Emergency Medicine CurrentSince Jun 1, 2006 Accepting new patients
Associates for Inpatient Medicine, LLC Past Accepting new patients
Nevada Em-I Silver-Homansky Medical Services Professional Corporation Emergency Medicine Past Accepting new patients

Locations

1600 W Antelope Dr
Layton, UT 84041
Phone (801) 807-1000

630 Medical Dr
North Salt Lake, UT 84010
Phone (801) 292-6231

2690 N 600 W
Pleasant View, UT 84414
Phone (801) 786-7911

3451 W 5600 S
Roy, UT 84067
Phone (801) 896-5600

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

2055 N Main St
Tooele, UT 84074
Phone (435) 843-3600

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 964-3111

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1720080369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 KATY FWY STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770791902",
            "telephone_number": "281-600-5000",
            "fax_number": "281-605-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2086 N 1700 W STE D",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411164",
            "telephone_number": "385-515-4100",
            "fax_number": "385-351-1150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 N Tenaya Way",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280436",
            "country_code": "US",
            "telephone_number": "702-255-5025",
            "fax_number": "702-255-5015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOVERIDGE",
        "first_name": "BRIAN",
        "middle_name": "WILLARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "10269",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NV",
            "license": "10269",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018840",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.