Individual provider Active NPI

Anne G Baranko, M.D.

  • Pediatric Adolescent Medicine Physician
  • Ogden, UT
National Provider Identifier
1962595256
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
365626-1205 Issued in UT
Practice address
3955 Harrison Blvd
L-1
Ogden, UT 84403-2313
Phone
(801) 621-1701
Fax
(801) 393-9411
NPI assigned
Oct 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 365626-1205 UT Primary

Addresses

Primary practice location

3955 Harrison Blvd
L-1
Ogden, UT 84403-2313

Mailing address

3955 Harrison Blvd
L-1
Ogden, UT 84403-2313
Phone (801) 621-1701

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
I20150515001248 UT Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4587984463

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
365626-1205UTMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wasatch Pediatrics, Inc Past Accepting new patients
Pediatric Care of Ogden Past Accepting new patients
Pediatric Care of Ogden Past Accepting new patients

Organizations & group practices 3

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": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962595256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 HARRISON BLVD",
            "address_2": "L-1",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844032313",
            "telephone_number": "801-621-1701",
            "fax_number": "801-393-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 HARRISON BLVD",
            "address_2": "L-1",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844032313",
            "telephone_number": "801-621-1701",
            "fax_number": "801-393-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARANKO",
        "first_name": "ANNE",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "UT",
            "license": "365626-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.