Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Coulson Dirk Boggess, PA-C

Individual provider Physician Assistant · NPI 1215829775

Coulson Dirk Boggess, PA-C is a Physician Assistant in Park City, Utah. Qualified in 2025, 1 year ago. Practices with Rosenberg Cooley Metcalf Lc, a 36-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
1
Licensed in
UT
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

900 Round Valley Dr Ste 100
Park City, UT 84060-7552
Phone: (435) 655-6600
Fax: (435) 655-2388
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 6340 S 3000 E Ste 200, Cottonwood Heights, UT 84121-3552 — (435) 655-6600
  • 380 E 1500 S Ste 103, Heber City, UT 84032-3940 — (435) 655-6600

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 14268687-1206 (UT)

Record details

NPI number1215829775
Entity typeIndividual (Type 1)
GenderNot disclosed
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 18, 2025
Last updated in NPPESMarch 4, 2026
Certification dateMarch 4, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Rosenberg Cooley Metcalf Lc — 36 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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