Bryan Weed, MD
Individual provider Active NPI Pediatrics Physician · Vineyard, UT
NPI 1801384409 · NPPES record last updated Jul 9, 2021
Key facts
- NPI
- 1801384409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 12198837-1205 (UT)
- Practice address
- 747 E 440 N Ste a
Vineyard, UT 84059-8121 - Phone
- (801) 357-7883
- NPI assigned
- Apr 29, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190905001042 | NY | Order and Referring Only - Pediatric Medicine |
1254660947 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12198837-1205 | UT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utah Valley Pediatrics L.L.C. | Pediatrics | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 12198837-1205 | UT | Yes |
Addresses
Primary practice location
747 E 440 N Ste a
Vineyard, UT 84059-8121
Mailing address
747 E 440 N Ste a
Orem, UT 84059-8121
Phone (607) 427-6173
Other providers in Vineyard, UT
- Vineyard Surgery Center, LLC
- Vineyard Surgery Center, LLC
- Rebecca Ann Waite
- Connan Wallace
- Leticia Bench Wasden
- Brett Wheatfill
- Wholebility
- Bailey Wilson
- David Wilson
- Erin Riley Wilson
All providers in Vineyard, UT · Pediatrics Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.