Organization Active NPI

Rodrick D McKinlay MD PC

  • Surgery Physician
  • Salt Lake City, UT
National Provider Identifier
1053326702
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
RODRICK D MCKINLAY MD PC
Practice address
1521 E 3900 S Ste 100
Salt Lake City, UT 84124-1550
Phone
(801) 268-3800
Fax
(801) 268-3997
NPI assigned
Jul 30, 2006
Last updated
Feb 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Authorized official

Name
Rodrick D McKinlay, MDNPI 1245245992
Title
Doctor
Phone
(801) 268-3800

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1521 E 3900 S Ste 100
Salt Lake City, UT 84124-1550

Mailing address

1521 E 3900 S Ste 100
Salt Lake City, UT 84124-1550
Phone (801) 268-3800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040907001043 UT Part B Supplier - Clinic/Group Practice 1951377399 Receives reassigned benefits from 1 practitioner
Practice locations: Salt Lake City, UT

National Provider Directory

National Provider Directory

Locations

1521 E 3900 S
Ste 100
Salt Lake City, UT 84124
Phone (801) 268-3800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1053326702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 E 3900 S STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241550",
            "telephone_number": "801-268-3800",
            "fax_number": "801-268-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 E 3900 S STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241550",
            "telephone_number": "801-268-3800",
            "fax_number": "801-268-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODRICK D MCKINLAY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "MCKINLAY",
        "authorized_official_first_name": "RODRICK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "801-268-3800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.