Individual provider Active NPI

Stephen A Spurlock, PA-C

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1790093201
Registry record updated Dec 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
258981-1206 Issued in UT
Practice address
22 S 900 E
Salt Lake City, UT 84102-1307
Phone
(801) 328-2522
NPI assigned
Sep 17, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 258981-1206 UT Primary
Physician Assistant 363A00000X 8156 WI

Addresses

Primary practice location

22 S 900 E
Salt Lake City, UT 84102-1307

Mailing address

22 S 900 E
Salt Lake City, UT 84102-1307
Phone (801) 328-2522

Other practice location 1

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com
Direct Messaging Address sspurlock673201@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101101001120 UT Practitioner - Physician Assistant 4880888023 Reassigns benefits to 2 organizations
I20241101000779 WI Practitioner - Physician Assistant 4880888023 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians

Practice addresses (Care Compare)

1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500
Phone (801) 581-2121

430 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 929-2300

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

Hospital & facility affiliations

  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009
  • SSM Health St Agnes Hospital-Fond Du Lac Hospital, Fond Du Lac, WI, CCN 520088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
258981-1206UTMDPhysician Assistant
8156WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc CurrentSince Oct 28, 2024 Accepting new patients
University of Utah Adult Services CurrentSince Dec 15, 2023 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
Marshfield Clinic Inc CurrentSince Oct 28, 2024 Accepting new patients
University of Utah Adult Services CurrentSince Dec 15, 2023 Accepting new patients
Flambeau Hospital Inc CurrentSince Oct 28, 2024 Accepting new patients
Memorial Hospital Inc CurrentSince Oct 28, 2024 Accepting new patients
Agnesian Healthcare Inc CurrentSince Nov 1, 2025 Accepting new patients
Memorial Hospital Inc CurrentSince Oct 28, 2024 Accepting new patients
Agnesian Healthcare Inc CurrentSince Nov 1, 2025 Accepting new patients
Physician Group of Utah Inc CurrentSince Nov 10, 2019 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Oct 28, 2024 Accepting new patients
MCHS Hospitals Inc CurrentSince Oct 28, 2024 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Oct 28, 2024 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Oct 28, 2024 Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients

Locations

5979 S Fashion Blvd
Salt Lake Cty, UT 84107
Phone (801) 263-0140

82 S 1100 E
Ste 103
Salt Lake Cty, UT 84102
Phone (801) 505-5370

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100

2530 W 4700 S
Ste B8
Taylorsville, UT 84129
Phone (801) 967-5866

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 4

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": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733616000000",
    "number": "1790093201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021307",
            "telephone_number": "801-328-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021307",
            "telephone_number": "801-328-2522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N OAK AVE",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "544495703",
            "country_code": "US",
            "telephone_number": "715-387-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPURLOCK",
        "first_name": "STEPHEN",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-17",
        "last_updated": "2024-12-08",
        "certification_date": "2024-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "258981-1206",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "8156",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1000 N OAK AVE",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sspurlock673201@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.