Individual provider Active NPI

Ryan Greenwood, MD

  • Internal Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1962680793
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7670972-1205 Issued in UT
Practice address
1200 E 3900 S
Suite 4B
Salt Lake City, UT 84124-1300
Phone
(866) 500-7071
Fax
(866) 500-7081
NPI assigned
Feb 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7670972-1205 UT Primary

Addresses

Primary practice location

1200 E 3900 S
Suite 4B
Salt Lake City, UT 84124-1300

Mailing address

P.O. Box 9677
Salt Lake City, UT 84109-9677
Phone (866) 500-7071

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
I20100914001381 UT Practitioner - Internal Medicine 1052436060 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7670972-1205UTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Regional Hospitalists LLC CurrentSince Nov 21, 2014 Accepting new patients
Utah Regional Hospitalists LLC CurrentSince Nov 21, 2014 Accepting new patients

Locations

11925 S State St
Draper, UT 84020
Phone (801) 545-8000

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111

5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111

2055 N Main St
Tooele, UT 84074
Phone (435) 843-3600

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 964-3111

Organizations & group practices 2

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": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1962680793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 9677",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841099677",
            "telephone_number": "866-500-7071",
            "fax_number": "866-500-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E 3900 S",
            "address_2": "SUITE 4B",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241300",
            "telephone_number": "866-500-7071",
            "fax_number": "866-500-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWOOD",
        "first_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-04",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "7670972-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.