Individual provider Active NPI

Corey D Anden, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Ogden, UT
National Provider Identifier
1861490278
Registry record updated Jan 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
1780291205 Issued in UT
Practice address
4403 Harrison Blvd Ste 1875
Ogden, UT 84403-3325
Phone
(801) 387-2090
Fax
(801) 387-6606
NPI assigned
Jul 9, 2005
Last updated
Jan 8, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 1780291205 UT Primary

Addresses

Primary practice location

4403 Harrison Blvd Ste 1875
Ogden, UT 84403-3325

Mailing address

PO Box 27688
Salt Lake City, UT 84127-0688
Phone (801) 534-1360

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
I20040416000484 UT Practitioner - Physical Medicine and Rehabilitation 2163416181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Pittsburgh School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6112 S 1550
Suite 202
Ogden, UT 84405-5608
Phone (801) 732-5914

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1780291205UTMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Corey D Anden MD PC CurrentSince Oct 1, 2003 Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients

Locations

4403 Harrison Blvd
Ste 1875
South Ogden, UT 84403
Phone (801) 387-2090

6112 S 1550 E
Ste 202
South Ogden, UT 84405
Phone (385) 432-3240

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1120867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262908800000",
    "number": "1861490278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27688",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270688",
            "telephone_number": "801-534-1360",
            "fax_number": "801-366-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 1875",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033325",
            "telephone_number": "801-387-2090",
            "fax_number": "801-387-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDEN",
        "first_name": "COREY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-09",
        "last_updated": "2010-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "UT",
            "license": "1780291205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.