Individual provider Active NPI

Dylan S. Adams, MD

  • Neurological Surgery Physician
  • Salt Lake City, UT
National Provider Identifier
1770110074
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
13382592-1205 Issued in UT
Practice address
175 N Medical Drive East 5TH Floor
Salt Lake City, UT 84132-1473
Phone
(801) 581-2121
NPI assigned
Mar 25, 2020
Last updated
May 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 13382592-1205 UT Primary

Addresses

Primary practice location

175 N Medical Drive East 5TH Floor
Salt Lake City, UT 84132-1473

Mailing address

2889 Sollie Rd Apt 512
Mobile, AL 36695-5541

Other practice location 1

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-2345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20200630000939 VT Order and Referring Only - NeurosurgeryPractitioner - Neurosurgery 5092137562

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13382592-1205UTMDNeurological Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1770110074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2889 SOLLIE RD APT 512",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366955541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 N MEDICAL DRIVE EAST 5TH FLOOR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841321473",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Colchester Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054011473",
            "country_code": "US",
            "telephone_number": "802-847-2345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "DYLAN",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "UT",
            "license": "13382592-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.