NPIMap

Organization Active NPI

University of Utah Adult Services

  • Cardiovascular Disease Physician
  • Wilson, WY
National Provider Identifier
1043697683
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
UNIVERSITY OF UTAH ADULT SERVICES
Practice address
5235 HHR Ranch Rd
Wilson, WY 83014-9210
Phone
(801) 581-2121
NPI assigned
May 4, 2015
Organization subpart
Yes
Parent organization
UNIVERSITY OF UTAH ADULT SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Authorized official

Name
Sean Mulvihill, MD
Title
Chief Medical Officer
Phone
(801) 581-2121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

5235 HHR Ranch Rd
Wilson, WY 83014-9210

Mailing address

PO Box 413033
Salt Lake City, UT 84141-3033

Other names 1

  • WILSON MEDICAL HOLDINGS-Cardiology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150625001685 WY Part B Supplier - Clinic/Group Practice 0941525273 Receives reassigned benefits from 94 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rock Springs, WY; Jackson, WY; Evanston, WY

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

National Provider Directory

National Provider Directory
Part of
University of Utah Adult Services

Practitioners & affiliated clinicians

Practitioners 2

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": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1043697683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413033",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841413033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5235 HHR RANCH RD",
            "city": "WILSON",
            "state": "WY",
            "postal_code": "830149210",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "MULVIHILL",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "801-581-2121",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WILSON MEDICAL HOLDINGS-Cardiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilson, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.