Geoffrey Matthew Crockett, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5848509-1205 Issued in UT

Practice address

900 Round Valley Dr
Park City, UT 84060-7552

Phone

(435) 658-7000

NPI assigned

Mar 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Emergency Medicine

Education

Wayne State University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Park City Hospital Hospital, Park City, UT, CCN 460057
• Intermountain Health Heber Valley Hospital Hospital, Heber City, UT, CCN 461307

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ihc Health Services Inc

  • Critical Access Hospital
  • Heber City, UT
  • NPI 1316055205
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Salt Lake City, UT
  • NPI 1083624738
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Alta Medical Services PC

  • Urgent Care Clinic/Center
  • Alta, UT
  • NPI 1740348556
  NPD (past)
• Canyon Care LLC

  • Family Medicine Physician
  • Alta, UT
  • NPI 1417509860
  NPD (past)
• Emergency Physicians Integrated Care, LLC

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1578598199
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services Inc

  • Critical Access Hospital
  • Heber City, UT
  • NPI 1316055205
  Care Compare affiliation
• Ihc Health Services Inc

  • General Acute Care Hospital
  • Park City, UT
  • NPI 1851530984
  Care Compare affiliation

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1780645697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180",
            "telephone_number": "435-658-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 ROUND VALLEY DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607552",
            "telephone_number": "435-658-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "GEOFFREY",
        "middle_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "UT",
            "license": "5848509-1205",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "5848509-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D6280",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Cox, RPH
• Brittany Elizabeth Coyle, M.A. BCBA
• Ryan Patrick Coyle, OD
• Leslie Clark Crabb
• Creek Capital Park City LLC
• Marguerite Crosby, RD
• Stephanie Croteau, PHARMD
• Michelle R Croyle, PA-C
• Kirsten Cummings, CMHC
• Holly Elizabeth Cunningham

• Emergency Medicine Physician in Park City, UT
• Providers in Park City, UT by specialty
• Emergency Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.