Individual provider Active NPI

Garth J Guymon, MD

  • Anesthesiology Physician
  • Ogden, UT
National Provider Identifier
1760594337
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
85-173248-1205 Issued in UT
Practice address
4401 Harrison Boulevard
McKay Dee Hospital
Ogden, UT 84403
Phone
(801) 507-5248
Fax
(801) 733-5618
NPI assigned
Aug 31, 2006
Last updated
Oct 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 85-173248-1205 UT Primary

Addresses

Primary practice location

4401 Harrison Boulevard
McKay Dee Hospital
Ogden, UT 84403

Mailing address

3340 North Center St
#800
Lehi, UT 84043-7406
Phone (801) 990-1911

Other identifiers 14

IdentifierTypeStateIssuer
36719OtherUTDESERET MUTUAL
37787OtherUTPEHP
PRA03589OtherUTMOLINA
QM0000075886OtherUTALTIUS
107006085101OtherUTIHC
1502954OtherUTUMWA
2090168OtherUTUNITED HEALTHCARE
8597445OtherUTWORKERS COMP
870545614GU1OtherUTEDUCATORS MUTUAL
003050200MedicaidID
100501897MedicaidNV
108104700MedicaidWY
824707MedicaidAZ
53239OtherUTHEALTHY U

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85-173248-1205UTMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1760594337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 NORTH CENTER ST",
            "address_2": "#800",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840437406",
            "telephone_number": "801-990-1911",
            "fax_number": "801-990-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 HARRISON BOULEVARD",
            "address_2": "MCKAY DEE HOSPITAL",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "84403",
            "telephone_number": "801-507-5248",
            "fax_number": "801-733-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUYMON",
        "first_name": "GARTH",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "85-173248-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL",
            "identifier": "36719",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "37787",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "PRA03589",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "QM0000075886",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC",
            "identifier": "107006085101",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1502954",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2090168",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "8597445",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATORS MUTUAL",
            "identifier": "870545614GU1",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003050200",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100501897",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108104700",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "824707",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY U",
            "identifier": "53239",
            "state": "UT"
        }
    ],
    "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 Oct 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.