Individual provider Active NPI

Brennen Holt, M.D.

  • Emergency Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1831552066
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
10484722-1205 Issued in UT
Practice address
30 N 1900 E # 1C026
Salt Lake City, UT 84132-0002
Phone
(801) 581-2730
NPI assigned
Apr 4, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 10484722-1205 UT Primary

Addresses

Primary practice location

30 N 1900 E # 1C026
Salt Lake City, UT 84132-0002

Mailing address

30 N 1900 E # 1C026
Salt Lake City, UT 84132-0002
Phone (801) 581-2730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191101001054 UT Practitioner - Emergency Medicine 2961763016 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Utah School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Emergency PhysiciansGroup PAC ID 1153307277, 151 clinicians

Practice addresses (Care Compare)

5121 S Cottonwood St
Salt Lake City, UT 84107-5701
Phone (801) 507-9700

Hospital & facility affiliations

  • Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
  • Intermountain Health Layton Hospital Hospital, Layton, UT, CCN 460061

Merit-based Incentive Payment System (MIPS)

Final score
89.98 of 100Reported as group
Quality
85.2
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10484722-1205UTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Single Specialty Current Accepting new patients
Utah Emergency Physicians Single Specialty CurrentSince Nov 1, 2019 Accepting new patients
Ihc Health Services Inc CurrentSince Mar 1, 2020 Accepting new patients

Locations

1501 Hiland Ave
Burley, ID 83318
Phone (208) 678-4444

201 W Layton Pkwy
Layton, UT 84041
Phone (801) 543-6000

3741 W 12600 S
Riverton, UT 84065
Phone (801) 285-2400

8th Ave C St E
Salt Lake City, UT 84143
Phone (218) 929-0674

5373 S Green St
Salt Lake City, UT 84123
Phone (801) 442-2670

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417

4401 Harrison Blvd
South Ogden, UT 84403
Phone (801) 387-2800

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1831552066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E # 1C026",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E # 1C026",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "BRENNEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "10484722-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.