Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cody Brad Mickelsen, MD

Individual provider Anesthesiology Physician · NPI 1013159003

Cody Brad Mickelsen, MD is an Anesthesiology in Providence, Utah. Graduated from University of Vermont College of Medicine in 2013, 13 years ago. Practices with Interwest Anesthesia Associates LLC, a 27-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
13
Trained at
University of Vermont College of Medicine
Licensed in
UT
In the registry since
2009
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

560 W 465 N Ste 604
Providence, UT 84332-8006
Phone: (435) 753-1600
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 9806425-1205 (UT)

Record details

NPI number1013159003
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 6, 2009
Last updated in NPPESJuly 23, 2026
Certification dateJuly 23, 2026
Mailing address560 W 465 N Ste 604, Providence, UT 84332-8006

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolUNIVERSITY OF VERMONT COLLEGE OF MEDICINE
Graduated 2013 (13 years in practice)
Group practice Interwest Anesthesia Associates Llc — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Providence