NPIMap

Organization Active NPI

Riverwoods Anesthesia PLLC

  • Anesthesiology Physician
  • Provo, UT
National Provider Identifier
1821290883
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
RIVERWOODS ANESTHESIA PLLC
Practice address
320 River Park Dr Ste 195
Provo, UT 84604-6065
Phone
(801) 437-4500
Fax
(801) 374-9195
NPI assigned
Jun 1, 2007
Last updated
Apr 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Authorized official

Name
Clark S Ashby, MDNPI 1972624146
Title
Member
Phone
(801) 437-4500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

320 River Park Dr Ste 195
Provo, UT 84604-6065

Mailing address

320 River Park Dr Ste 195
Provo, UT 84604-6065
Phone (801) 437-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050405000096 UT Part B Supplier - Clinic/Group Practice 0547217366 Receives reassigned benefits from 16 practitioners
Practice locations: Provo, UT

National Provider Directory

National Provider Directory

Locations

280 River Park Dr
#100
Provo, UT 84604
Phone (801) 229-1009

320 River Park Dr
Ste 195
Provo, UT 84604
Phone (801) 375-8064

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1821290883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 RIVER PARK DR STE 195",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046065",
            "telephone_number": "801-437-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 RIVER PARK DR STE 195",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046065",
            "telephone_number": "801-437-4500",
            "fax_number": "801-374-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERWOODS ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "ASHBY",
        "authorized_official_first_name": "CLARK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "801-437-4500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.