Organization Active NPI

Urology Associates, LLC

  • Specialist
  • St George, UT
National Provider Identifier
1952436826
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
UROLOGY ASSOCIATES, LLC
Practice address
391 E 500 S
St George, UT 84770-3667
Phone
(435) 628-3606
Fax
(435) 628-8404
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

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

Authorized official

Name
Dr. Bryan Ellsworth, MD
Title
Physician
Phone
(435) 628-3606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X UT Primary

Addresses

Primary practice location

391 E 500 S
St George, UT 84770-3667

Mailing address

391 E 500 S
St George, UT 84770-3667
Phone (435) 628-3606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050728000767 UT Part B Supplier - Clinic/Group Practice 3577591809 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Saint George, UT
O20140815001132 NV Part B Supplier - Clinic/Group Practice 3577591809 Practice locations: Mesquite, NV

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

340 Falcon Ridge Pkwy
Ste 200
Mesquite, NV 89027
Phone (435) 628-3606

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9258/brand/1/csg/1/fhir/r4

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187568000000",
    "number": "1952436826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 E 500 S",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703667",
            "telephone_number": "435-628-3606",
            "fax_number": "435-628-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 E 500 S",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703667",
            "telephone_number": "435-628-3606",
            "fax_number": "435-628-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-08-20",
        "status": "A",
        "authorized_official_last_name": "ELLSWORTH",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "435-628-3606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.