Active NPI
E Dennis Genebach, MD
- Internal Medicine Physician
- Murray, UT
National Provider Identifier
1003833468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 1772461205
- Practice address
- 5801 Fashion Blvd
Murray, UT 84107-6159 - Phone
- (801) 314-4544
- NPI assigned
- Jul 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 1772461205 | UT | Primary |
Addresses
Primary practice location
5801 Fashion Blvd
Murray, UT 84107-6159
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 314-4544
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1772461205 | UT | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192406400000",
"number": "1003833468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128",
"telephone_number": "801-314-4544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5801 FASHION BLVD",
"city": "MURRAY",
"state": "UT",
"postal_code": "841076159",
"telephone_number": "801-314-4544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENEBACH",
"first_name": "E",
"middle_name": "DENNIS",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2007-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "UT",
"license": "1772461205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.