Individual provider Active NPI

Stephen Wilkinson, MD

  • Cardiovascular Disease Physician
  • Provo, UT
National Provider Identifier
1902149909
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
12773271-1205 Issued in UT
Practice address
395 W Bulldog Blvd
Provo, UT 84604-3311
Phone
(801) 357-7081
NPI assigned
Mar 28, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301115708 MI
Pediatrics Physician 208000000X 4301115708 MI
Cardiovascular Disease Physician 207RC0000X 12773271-1205 UT Primary
Internal Medicine Physician 207R00000X 4301115708 MI

Addresses

Primary practice location

395 W Bulldog Blvd
Provo, UT 84604-3311

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

2900 Bradford St NE
Grand Rapids, MI 49525
Phone (616) 885-5000

Other practice location 2

2900 Bradford St NE
Grand Rapids, MI 49525
Phone (616) 885-5000

Other practice location 3

605 Oak St
Big Rapids, MI 49307
Phone (616) 391-3139

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
I20220727000715 UT Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0840519021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Creighton University School of Medicine, 2013
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)

395 W Bulldog Blvd
Provo, UT 84604
Phone (801) 357-4141

Hospital & facility affiliations

  • Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001
  • American Fork Hospital Hospital, American Fork, UT, CCN 460023
  • Intermountain Health Spanish Fork Hospital Hospital, Spanish Fork, UT, CCN 460062
  • Intermountain Health Sevier Valley Hospital Hospital, Richfield, UT, CCN 460026
  • Intermountain Health Sanpete Valley Hospital Hospital, Mount Pleasant, UT, CCN 461303

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting41
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
149641CAMDMarriage & Family Therapist
4301115708MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Aug 14, 2022 Accepting new patients
Ihc Health Services, Inc. CurrentSince Aug 14, 2022 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

395 W Cougar Blvd
Provo, UT 84604
Phone (801) 357-4141

395 W Cougar Blvd
Ste 503
Provo, UT 84604
Phone (801) 357-4600

819 E Market Place Dr
Spanish Fork, UT 84660
Phone (385) 344-6600

819 E Market Place Dr
Ste 2C
Spanish Fork, UT 84660

Organizations & group practices 4

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 7

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": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1902149909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W BULLDOG BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043311",
            "telephone_number": "801-357-7081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 Bradford St NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "49525",
            "country_code": "US",
            "telephone_number": "616-885-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 Bradford St NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "49525",
            "country_code": "US",
            "telephone_number": "616-885-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "605 Oak St",
            "address_purpose": "LOCATION",
            "city": "Big Rapids",
            "state": "MI",
            "postal_code": "49307",
            "country_code": "US",
            "telephone_number": "616-391-3139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-28",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301115708",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301115708",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "UT",
            "license": "12773271-1205",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301115708",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.