NPIMap

Organization Active NPI

Summit Medical Care

  • Family Medicine Physician
  • Provo, UT
National Provider Identifier
1881216646
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUMMIT MEDICAL CARE
Practice address
777 N 500 W Ste 103
Provo, UT 84601-1552
Phone
(801) 253-6886
Fax
(801) 253-6888
NPI assigned
May 14, 2020
Last updated
May 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Authorized official

Name
Ryan Ellsworth, DPMNPI 1104130574
Title
Owner
Phone
(801) 550-0955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

777 N 500 W Ste 103
Provo, UT 84601-1552

Mailing address

9980 S 300 W Ste 310
Sandy, UT 84070-3654
Phone (801) 253-6886

Other practice location 1

12523 S Creek Meadow Rd Ste 105
Riverton, UT 84065-7299
Phone (801) 253-6886

Other practice location 2

3130 S Highland Dr Ste B4
Salt Lake City, UT 84106-3095
Phone (801) 253-6886

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1881216646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9980 S 300 W STE 310",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840703654",
            "telephone_number": "801-253-6886",
            "fax_number": "385-900-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N 500 W STE 103",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011552",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12523 S Creek Meadow Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Riverton",
            "state": "UT",
            "postal_code": "840657299",
            "country_code": "US",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3130 S Highland Dr Ste B4",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841063095",
            "country_code": "US",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUMMIT MEDICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-14",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "ELLSWORTH",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-550-0955",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.