NPIMap

Organization Active NPI

Male Fertility and Peyronie'S Clinic

  • Urology Physician
  • Orem, UT
National Provider Identifier
1013522564
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
MALE FERTILITY AND PEYRONIE'S CLINIC
Practice address
1443 W 800 N Ste 302
Orem, UT 84057-2883
Phone
(801) 655-0015
Fax
(801) 655-0048
NPI assigned
Sep 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Authorized official

Name
Landon Trost, MDNPI 1245434059
Title
Owner, MD
Phone
(801) 655-0015

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1443 W 800 N Ste 302
Orem, UT 84057-2883

Mailing address

1443 W 800 N Ste 302
Orem, UT 84057-2883
Phone (801) 655-0015

National Provider Directory

National Provider Directory

Locations

1443 W 800 N
Ste 202
Orem, UT 84057

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1013522564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 W 800 N STE 302",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840572883",
            "telephone_number": "801-655-0015",
            "fax_number": "801-655-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1443 W 800 N STE 302",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840572883",
            "telephone_number": "801-655-0015",
            "fax_number": "801-655-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALE FERTILITY AND PEYRONIE'S CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-11",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "TROST",
        "authorized_official_first_name": "LANDON",
        "authorized_official_title_or_position": "OWNER, MD",
        "authorized_official_telephone_number": "801-655-0015",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.