Active NPI
Edward William Parker, M.D.
- Specialist
- Pleasant Grove, UT
National Provider Identifier
1801855010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 161706-1205
- Practice address
- 1886 W 800 N
Pleasant Grove, UT 84062-4097 - Phone
- (801) 756-5288
- Fax
- (801) 756-7589
- NPI assigned
- Mar 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 161706-1205 | UT | Primary |
Addresses
Primary practice location
1886 W 800 N
Pleasant Grove, UT 84062-4097
Mailing address
1055 N 500 W
Provo, UT 84604-3305
Phone (801) 756-5288
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05784 | Medicaid | UT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 161706-1205 | UT | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mount Timpanogos Womens Health, Inc | Past | Accepting new patients | |
| Revere Health PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Obstetrics Physician
- Pleasant Grove, UT
- NPI 1669435814
-
- Multi-Specialty Clinic/Center
- Spanish Fork, UT
- NPI 1851142285
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262131200000",
"number": "1801855010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 N 500 W",
"city": "PROVO",
"state": "UT",
"postal_code": "846043305",
"telephone_number": "801-756-5288",
"fax_number": "801-756-7589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1886 W 800 N",
"city": "PLEASANT GROVE",
"state": "UT",
"postal_code": "840624097",
"telephone_number": "801-756-5288",
"fax_number": "801-756-7589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "EDWARD",
"middle_name": "WILLIAM",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2009-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "UT",
"license": "161706-1205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05784",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Grove, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.