Brent Donald Wilson, M.D., PH.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

4984011-1205 Issued in UT

Practice address

30 N 1900 E
Room 4A100 Som
Salt Lake City, UT 84132-0002

Phone

(801) 585-7676

Fax

(801) 581-7735

NPI assigned

Jul 7, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT, WY, NV3 enrollments

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 3

Specialty

Cardiovascular Disease (Cardiology)

Education

Stanford University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Medical Center Hospital, Murray, UT, CCN 460010
• LDS Hospital Hospital, Salt Lake City, UT, CCN 460006
• Intermountain Health Alta View Hospital Hospital, Sandy, UT, CCN 460044
• Park City Hospital Hospital, Park City, UT, CCN 460057
• Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group NPD
• Tooele Clinic Corp

  • Family Medicine Physician
  • Tooele, UT
  • NPI 1073512364

  Internal Medicine

  Medicare reassignment NPD
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• North Lincoln County Hospital District

  • Critical Access Hospital
  • Afton, WY
  • NPI 1255376406
  Medicare reassignment NPD
• University of Utah Adult Services

  • Vascular Surgery Physician
  • Rock Springs, WY
  • NPI 1104204361
  Medicare reassignment NPD
• University of Utah Adult Services

  • Clinical Cardiac Electrophysiology Physician
  • Ely, NV
  • NPI 1891172458
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Pediatrics Physician
  • Riverton, UT
  • NPI 1518108166
  NPD
• University of Utah Adult Services

  • Vascular & Interventional Radiology Physician
  • Salt Lake City, UT
  • NPI 1457755258
  NPD
• University of Utah Adult Services

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• University of Utah Adult Services

  • Clinical Cardiac Electrophysiology Physician
  • Salt Lake City, UT
  • NPI 1851795652
  NPD
• University of Utah Adult Services

  • Clinical Cardiac Electrophysiology Physician
  • Afton, WY
  • NPI 1083091623
  NPD
• Ihc Health Services Inc

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1306888722

  Internal Medicine

  NPD (past)

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

• Ihc Health Services Inc

  • General Acute Care Hospital
  • Riverton, UT
  • NPI 1154551919
  Care Compare affiliation
• Ihc Health Services Inc

  • General Acute Care Hospital
  • Park City, UT
  • NPI 1851530984
  Care Compare affiliation
• Ihc Health Services Inc

  • General Acute Care Hospital
  • Sandy, UT
  • NPI 1962412486
  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650
  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1528078581
  Care Compare affiliation

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1831121938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-408-8112",
            "fax_number": "801-408-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E",
            "address_2": "ROOM 4A100 SOM",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-585-7676",
            "fax_number": "801-581-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRENT",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "4984011-1205",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "UT",
            "license": "4984011-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwilson6419@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": []
}

• Amy Wilson, M.D.
• Amy Wilson
• April Wilson
• April Elise Wilson, LCSW
• Audrey Helen Wilson
• Brianna Wilson
• Carly Jane Wilson
• Chalon Wilson
• Charlize Brielle Wilson
• Claudia F. Wilson, RD

• Cardiovascular Disease Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Cardiovascular Disease Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.