NPIMap

Individual provider Active NPI

Melissa Heidi Ludwig, PA-C

  • Physician Assistant
  • Bountiful, UT
National Provider Identifier
1992959522
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4797308-1206 Issued in UT
Practice address
380 N 200 W
Suite 209
Bountiful, UT 84010-7079
Phone
(801) 298-1300
Fax
(801) 296-6199
NPI assigned
Nov 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4797308-1206 UT Primary
Medical Physician Assistant 363AM0700X 4797308-1206 UT

Addresses

Primary practice location

380 N 200 W
Suite 209
Bountiful, UT 84010-7079

Mailing address

380 N 200 W
Suite 209
Bountiful, UT 84010-7079
Phone (801) 298-1300

Other identifiers 1

IdentifierTypeStateIssuer
P00662902OtherUTRR MEDICARE

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
I20081216000266 UT Practitioner - Physician Assistant 9830251438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Imaging Associates IncGroup PAC ID 1355394537, 45 clinicians

Practice addresses (Care Compare)

630 Medical Dr
Bountiful, UT 84010-4908
Phone (801) 299-2220

Hospital & facility affiliations

  • St Mark'S Hospital Hospital, Salt Lake City, UT, CCN 460047
  • Lone Peak Hospital Hospital, Draper, UT, CCN 460060
  • Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005
  • Lakeview Hospital Hospital, Bountiful, UT, CCN 460042

Merit-based Incentive Payment System (MIPS)

Final score
93.06 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4797308-1206UTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan Ridge Family Medicine LLC CurrentSince May 15, 2023 Accepting new patients
Tanner Memorial Clinic PastSince May 25, 2025 Accepting new patients
Tanner Memorial Clinic Past Accepting new patients
Scott E Southworth MD PC Past Accepting new patients

Locations

6321 S Redwood Rd
Ste 201
Taylorsville, UT 84123
Phone (801) 265-2212

Organizations & group practices 6

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 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": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268179200000",
    "number": "1992959522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 N 200 W",
            "address_2": "SUITE 209",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107079",
            "telephone_number": "801-298-1300",
            "fax_number": "801-296-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 N 200 W",
            "address_2": "SUITE 209",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107079",
            "telephone_number": "801-298-1300",
            "fax_number": "801-296-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDWIG",
        "first_name": "MELISSA",
        "middle_name": "HEIDI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2010-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "4797308-1206",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "4797308-1206",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00662902",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.