NPIMap

Organization Active NPI

Uou Pediatric Orthopedics

  • Pediatric Orthopaedic Surgery Physician
  • Salt Lake City, UT
National Provider Identifier
1073620100
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
Legal business name
UOU PEDIATRIC ORTHOPEDICS
Practice address
100 Mario Capecchi Dr
Salt Lake City, UT 84112-8924
Phone
(801) 588-3900
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Authorized official

Name
Alan Kendrick Stotts, MD
Title
Department Chair
Phone
(801) 588-3900

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Pediatric Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XP3100X Primary
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X
Orthopaedic Trauma PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0801X

Addresses

Primary practice location

100 Mario Capecchi Dr
Salt Lake City, UT 84112-8924

Mailing address

PO Box 58886
Salt Lake City, UT 84158-0886
Phone (801) 213-3800

Other identifiers 4

IdentifierTypeStateIssuer
200072630AOtherOKOKLAHOMA MEDICAID
122233300OtherWYWYOMING MEDICAID
805675500OtherIDIDAHO MEDICAID
100500963OtherNVNEVADA MEDICAID

National Provider Directory

National Provider Directory

Locations

100 N Mario Capecchi Dr
#455
Salt Lake City, UT 84113
Phone (801) 662-5600

100 N Mario Capecchi Dr
#4550
Slc, UT 84113
Phone (801) 662-5600

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315267200000",
    "number": "1073620100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58886",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841580886",
            "telephone_number": "801-213-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841128924",
            "telephone_number": "801-588-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UOU PEDIATRIC ORTHOPEDICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2011-09-06",
        "status": "A",
        "authorized_official_last_name": "STOTTS",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "KENDRICK",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "801-588-3900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA MEDICAID",
            "identifier": "200072630A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WYOMING MEDICAID",
            "identifier": "122233300",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO MEDICAID",
            "identifier": "805675500",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA MEDICAID",
            "identifier": "100500963",
            "state": "NV"
        }
    ],
    "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 Sep 6, 2011; 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.