Individual provider Active NPI

Marc Paul Hyde, MD

  • Emergency Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1962594879
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
355644-1205 Issued in UT
Practice address
2637 E Spring Hollow Dr
Salt Lake City, UT 84109-4036
Phone
(801) 910-1905
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 355644-1205 UT Primary
Emergency Medicine Physician 207P00000X 26154 NE

Addresses

Primary practice location

2637 E Spring Hollow Dr
Salt Lake City, UT 84109-4036

Mailing address

2637 E Spring Hollow Dr
Salt Lake City, UT 84109-4036
Phone (801) 910-1905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110606000119 NE Practitioner - Emergency Medicine 1759484991 Reassigns benefits to 1 organization
I20161020002337 GA Practitioner - Emergency Medicine 1759484991 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26154NEMDEmergency Medicine Physician
355644-1205UTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Platte Nebraska Hospital Corporation Current Accepting new patients
Houston County Emergency Group, LLC Emergency Medicine CurrentSince Sep 1, 2016 Accepting new patients
Georgia Emergency Group, LLC Emergency Medicine CurrentSince Dec 10, 2016 Accepting new patients
Houston County Emergency Group, LLC Emergency Medicine CurrentSince Sep 1, 2016 Accepting new patients
North Platte Nebraska Hospital Corporation CurrentSince Apr 8, 2018 Accepting new patients
Crum,Stefanko and Jones LTD Emergency Medicine Past Accepting new patients
Alegent Creighton Health Emergency Medicine Past Accepting new patients

Locations

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1962594879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2637 E SPRING HOLLOW DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841094036",
            "telephone_number": "801-910-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2637 E SPRING HOLLOW DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841094036",
            "telephone_number": "801-910-1905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDE",
        "first_name": "MARC",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "355644-1205",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "26154",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.