NPIMap

Individual provider Active NPI

Wesley S Bott, DO

  • Family Medicine Physician
  • Santaquin, UT
National Provider Identifier
1760659130
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7925403-1204 Issued in UT
Practice address
94 W Main St
Santaquin, UT 84655-5655
Phone
(801) 754-3122
Fax
(801) 754-0197
NPI assigned
May 14, 2008
Last updated
Aug 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02003547A IN
Family Medicine Physician 207Q00000X 7925403-1204 UT Primary

Addresses

Primary practice location

94 W Main St
Santaquin, UT 84655-5655

Mailing address

325 W Center St
Spanish Fork, UT 84660-2060
Phone (801) 798-7301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110712000627 UT Practitioner - Family Practice 8325184328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Canyon View Medical Group LLCGroup PAC ID 9739084351, 30 clinicians

Practice addresses (Care Compare)

94 W Main St
Santaquin, UT 84655-5655
Phone (801) 754-3122

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Canyon View Medical Group LLC Family Medicine CurrentSince Jul 1, 2011 Accepting new patients
Canyon View Medical Group LLC Current Accepting new patients
Canyon View Medical Group LLC Family Medicine CurrentSince Jul 1, 2011 Accepting new patients
Fort Wayne Medical Education Program Family Medicine PastSince Sep 1, 2024 Accepting new patients

Locations

94 W Main St
Santaquin, UT 84655
Phone (801) 754-3122

325 W Center St
Spanish Fork, UT 84660
Phone (801) 798-7301

336 W 100 S
Spanish Fork, UT 84660
Phone (385) 203-0246

Interoperability endpoints

  • Direct secure messaging: wesley.bott.p1@direct.canyonviewmed.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mervyn Sharp Bennion Central Utah Veterans HomePayson, UT, CCN 465181 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 1, 2016
Nov 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 10

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": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1760659130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W CENTER ST",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846602060",
            "telephone_number": "801-798-7301",
            "fax_number": "801-798-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 W MAIN ST",
            "city": "SANTAQUIN",
            "state": "UT",
            "postal_code": "846555655",
            "telephone_number": "801-754-3122",
            "fax_number": "801-754-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTT",
        "first_name": "WESLEY",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-14",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02003547A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "7925403-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santaquin, UT

Sources for this page

Verify at the official NPI Registry.