NPIMap

Individual provider Active NPI

Adam Kimball Bevan, M.D., PH.D.

  • Neurological Surgery Physician
  • Provo, UT
National Provider Identifier
1992110787
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
12335173-1205 Issued in UT
Practice address
1055 N 300 W Ste 400
Provo, UT 84604-3359
Phone
(801) 357-7404
Fax
(801) 357-7587
NPI assigned
Jul 1, 2014
Last updated
Jul 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 2014019153 MO
Neurological Surgery Physician 207T00000X 12335173-1205 UT Primary

Addresses

Primary practice location

1055 N 300 W Ste 400
Provo, UT 84604-3359

Mailing address

1055 N 300 W Ste 400
Provo, UT 84604-3359
Phone (801) 357-7404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210804003260 UT Practitioner - Neurosurgery 6709006117 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Ohio State University College of Medicine, 2014
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)

1034 N 500
Provo, UT 84604-3380
Phone (801) 357-7850

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion176
Laminectomy or laminotomy (partial removal of spine bones)78

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jun 8, 2022 Accepting new patients
Ihc Health Services Inc CurrentSince Jan 8, 2023 Accepting new patients
Utah Neurological Clinic, PC Neurological Surgery CurrentSince Aug 1, 2021 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Jun 8, 2022 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

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

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

1055 N 300 W
Ste 400
Provo, UT 84604
Phone (801) 357-7404

395 W Cougar Blvd
Ste 801
Provo, UT 84604
Phone (801) 229-1054

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1992110787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 300 W STE 400",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043359",
            "telephone_number": "801-357-7404",
            "fax_number": "801-357-7587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N 300 W STE 400",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043359",
            "telephone_number": "801-357-7404",
            "fax_number": "801-357-7587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVAN",
        "first_name": "ADAM",
        "middle_name": "KIMBALL",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-01",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "2014019153",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "UT",
            "license": "12335173-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.