Individual provider Active NPI

Theophilus E Owan, M.D.

  • Interventional Cardiology Physician
  • Salt Lake City, UT
National Provider Identifier
1982682647
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
6543761-1205 Issued in UT
Practice address
100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone
(801) 662-5400
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 6543761-1205 UT Primary

Addresses

Primary practice location

100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103

Mailing address

PO Box 413033
Salt Lake City, UT 84141-3033
Phone (801) 213-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV2 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
I20100922001007 UT Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 3375456312 Reassigns benefits to 3 organizations
I20210113001792 NV Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 3375456312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

1301 Bertha Howe Ave
Suite 6
Mesquite, NV 89027-7503
Phone (435) 251-2500

1380 E Medical Ctr Dr
Suite 1500
St George, UT 84790-2128
Phone (435) 251-2500

2650 N Tenaya Way
Suite 201
Las Vegas, NV 89128-1110
Phone (702) 736-7154

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting68
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6543761-1205UTMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Ihc Health Services Inc Interventional Cardiology CurrentSince Oct 13, 2020 Accepting new patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Ihc Health Services Inc CurrentSince Apr 24, 2018 Accepting new patients
Ihc Health Services Inc CurrentSince Apr 24, 2018 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Apr 24, 2018 Accepting new patients
Ihc Health Services Inc Past Accepting new patients
Mayo Clinic Past Accepting new patients

Locations

2650 N Tenaya Way
Ste 201
Las Vegas, NV 89128
Phone (702) 736-7154

1303 N Main St
Cedar City, UT 84721
Phone (435) 586-2229

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

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

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

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
Ste 2600
St George, UT 84790
Phone (435) 251-2700

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

1380 E Medical Center Dr
Ste 4100
St George, UT 84790
Phone (435) 251-2900

1380 E Medical Center Dr
Ste 1500
St George, UT 84790
Phone (435) 251-2500

Organizations & group practices 12

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.

Hospital & facility affiliations 3

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1982682647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413033",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841413033",
            "telephone_number": "801-213-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWAN",
        "first_name": "THEOPHILUS",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "UT",
            "license": "6543761-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.