Individual provider Active NPI

William Bennett Ennen, M.D.

  • Anesthesiology Physician
  • Murray, UT
National Provider Identifier
1770743403
Registry record updated Jun 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
11238688-1205 Issued in UT
Practice address
5121 S Cottonwood St
Murray, UT 84107
Phone
(801) 507-7000
NPI assigned
Jun 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A104930 CA
Anesthesiology Physician 207L00000X 11238688-1205 UT Primary

Addresses

Primary practice location

5121 S Cottonwood St
Murray, UT 84107

Mailing address

3340 N Center St Ste 800
Lehi, UT 84043-7406
Phone (650) 315-9598

Other practice location 1

5121 S Cottonwood St
Murray, UT 84107
Phone (801) 507-7000

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
I20190620003313 UT Practitioner - Anesthesiology 3678723368 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Chicago, Pritzker School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain West Anesthesia LLCGroup PAC ID 9032018502, 267 clinicians

Practice addresses (Care Compare)

1034 N 500
Provo, UT 84604-3380
Phone (801) 357-7850

Hospital & facility affiliations

  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
89.3
Improvement activities
40
Cost
78.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11238688-1205UTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Mountain West Anesthesia LLC Anesthesiology CurrentSince Apr 29, 2019 Accepting new patients
Ihc Health Services Inc CurrentSince Mar 1, 2020 Accepting new patients
Group Anesthesia Services Inc., a Medical Corporation Anesthesiology Past Accepting new patients

Locations

3340 N Center St
Ste 800
Lehi, UT 84043
Phone (800) 501-4788

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

150 W Civic Center Dr
Ste 200
Sandy, UT 84070
Phone (801) 727-2056

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

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 and National Provider Directory roles.

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561161600000",
    "number": "1770743403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 N CENTER ST STE 800",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840437406",
            "telephone_number": "650-315-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "84107",
            "telephone_number": "801-507-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5121 S Cottonwood St",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "84107",
            "country_code": "US",
            "telephone_number": "801-507-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENNEN",
        "first_name": "WILLIAM",
        "middle_name": "BENNETT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2019-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A104930",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "11238688-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.