NPIMap

Organization Active NPI

Ashley Valley Physician Practice, LLC

Doing business as Ashley Regional Internal Medicine

  • Hospitalist Physician
  • Vernal, UT
National Provider Identifier
1952631400
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
ASHLEY VALLEY PHYSICIAN PRACTICE, LLC
Doing business as
Ashley Regional Internal Medicine
Practice address
150 W 100 N
Vernal, UT 84078-2036
Phone
(435) 789-3342
Fax
(435) 789-1314
NPI assigned
Jan 6, 2010
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X
Neurology Physician 2084N0400X
Surgery Physician 208600000X
Hospitalist Physician 208M00000X Primary

Addresses

Primary practice location

150 W 100 N
Vernal, UT 84078-2036

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000

Other names 1

  • Ashley Regional Internal Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050119001166 UT Part B Supplier - Clinic/Group Practice 4284683947 Receives reassigned benefits from 57 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vernal, UT; Roosevelt, UT; Price, UT

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1952631400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W 100 N",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840782036",
            "telephone_number": "435-789-3342",
            "fax_number": "435-789-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLEY VALLEY PHYSICIAN PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ashley Regional Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ashley Regional Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vernal, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.