NPIMap

Individual provider Active NPI

Brian Tyler Melville, D.O.

  • Family Medicine Physician
  • Ogden, UT
National Provider Identifier
1982085718
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
76705991204 Issued in UT
Practice address
3945 Washington Blvd Ste a
Ogden, UT 84403-1825
Phone
(801) 479-4105
NPI assigned
Jun 17, 2015
Last updated
Jul 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 76705991204 UT Primary

Addresses

Primary practice location

3945 Washington Blvd Ste a
Ogden, UT 84403-1825

Mailing address

4403 Harrison Blvd Ste 3875
Ogden, UT 84403-3332
Phone (801) 387-7950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, UT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180607001174 WY Practitioner - Family Practice 6204145733 Reassigns benefits to 2 organizations
I20220113002527 UT Practitioner - Family PracticePractitioner - Internal Medicine 6204145733 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

4403 Harrison Blvd
Suite 3875
Ogden, UT 84403-3332
Phone (801) 387-7950

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76705991204UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Aug 28, 2022 Accepting new patients
University of Wyoming Speech and Hearing Clinic CurrentSince Jul 30, 2018 Accepting new patients
University of Wyoming Family Medicine CurrentSince Jul 30, 2018 Accepting new patients
University of Wyoming Family Medicine Current Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Sound Physicians of Wyoming, LLC Family Medicine CurrentSince Apr 21, 2018 Accepting new patients
Ihc Health Services Inc CurrentSince Aug 28, 2022 Accepting new patients
Ihc Health Services Inc Past Accepting new patients
University of Wyoming Family Medicine Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

4403 Harrison Blvd
Ste 3857
Ogden, UT 84403

4403 Harrison Blvd
Ste 3875
Ogden, UT 84403
Phone (801) 387-7950

1233 E 2nd St
Casper, WY 82601
Phone (307) 577-2171

1522 E A St
Casper, WY 82601
Phone (307) 233-6000

820 E 17th St
Cheyenne, WY 82001
Phone (307) 431-5055

2710 Harney St
Ste 202204
Laramie, WY 82072
Phone (307) 431-5055

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1982085718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 3875",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033332",
            "telephone_number": "801-387-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3945 WASHINGTON BLVD STE A",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844031825",
            "telephone_number": "801-479-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELVILLE",
        "first_name": "BRIAN",
        "middle_name": "TYLER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "76705991204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.