Individual provider Active NPI

Louis Mizell Jr., M.D.

  • Specialist
  • Murray, UT
National Provider Identifier
1851396964
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
82-168364-1205 Issued in UT
Practice address
164 E 5900 S Ste A112
Murray, UT 84107-7274
Phone
(385) 478-8975
Fax
(801) 269-9894
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 168364-1205 UT
Pediatric Gastroenterology Physician 2080P0206X 23893 ND
Specialist 174400000X 82-168364-1205 UT Primary

Addresses

Primary practice location

164 E 5900 S Ste A112
Murray, UT 84107-7274

Mailing address

164 E 5900 S Ste A112
Murray, UT 84107-7274
Phone (385) 478-8975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, FL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20211122002821 UT Practitioner - Pediatric MedicinePractitioner - Other (Physician) 3375889728
I20251013000060 FL Practitioner - Gastroenterology 3375889728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Tulane University School of Medicine, 1979
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10140 Centurion Pkwy N
Jacksonville, FL 32256-0532

PO Box
Suite 5074
Sioux Falls, SD 57117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82-168364-1205UTMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Sep 3, 2025 Accepting new patients
The Nemours Foundation CurrentSince Sep 3, 2025 Accepting new patients
The Nemours Foundation Current Accepting new patients
Pediatric Gastroenterology Pediatric Gastroenterology Current Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

8331 N Davis Hwy
Spc Care
Pensacola, FL 32514
Phone (850) 505-4700

8331 N Davis Hwy
Pensacola, FL 32514
Phone (850) 505-4700

164 E 5900 S
Ste A112
Salt Lake City, UT 84107
Phone (801) 262-2673

Interoperability endpoints

  • Direct secure messaging: lmizell154046@direct.nemours.org
  • Direct secure messaging: pediatricgastroenterology.louisleemizell@159382.advancedmd-direct.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1851396964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 E 5900 S STE A112",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077274",
            "telephone_number": "385-478-8975",
            "fax_number": "801-269-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 E 5900 S STE A112",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077274",
            "telephone_number": "385-478-8975",
            "fax_number": "801-269-9894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZELL JR.",
        "first_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "UT",
            "license": "168364-1205",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "ND",
            "license": "23893",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "82-168364-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.