Spenser Ryan Squire, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12767284-1205 Issued in UT

Practice address

12473 S Minuteman Dr
Draper, UT 84020-7870

Phone

(801) 495-7910

Fax

(801) 495-7990

NPI assigned

Apr 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Saint Louis University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

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

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Homecare Home Health Salt Lake Home health agency, South Jordan, UT, CCN 467030
• Intermountain Health Alta View Hospital Hospital, Sandy, UT, CCN 460044
• LDS Hospital Hospital, Salt Lake City, UT, CCN 460006
• Intermountain Medical Center Hospital, Murray, UT, CCN 460010
• Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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
• Ihc Health Services Inc

  • Geriatric Medicine (Internal Medicine) Physician
  • Murray, UT
  • NPI 1245519859
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  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

  • Home Health Agency
  • South Jordan, UT
  • NPI 1447344098
  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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1851854897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12473 S MINUTEMAN DR",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207870",
            "telephone_number": "801-495-7910",
            "fax_number": "801-495-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12473 S MINUTEMAN DR",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207870",
            "telephone_number": "801-495-7910",
            "fax_number": "801-495-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRE",
        "first_name": "SPENSER",
        "middle_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "12767284-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer J Hardenbrook MD PC
• Samantha Stone Spencer, PT, DPT
• Katelyn Spies
• Spring Gardens Draper Opco LLC
• Natalie Squire
• Vittawat Sriphongngarm, BCBA
• Maria Staker
• Daniel R Stampfl, MD
• Jessica M Stamps
• Lauren Elise Stanford, PA-C

• Family Medicine Physician in Draper, UT
• Providers in Draper, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.