NPIMap

Organization Active NPI

Universal Healthservices Inc.

Doing business as Provo Canyon School

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Orem, UT
National Provider Identifier
1073829057
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
126677-3902 Issued in UT
Legal business name
UNIVERSAL HEALTHSERVICES INC.
Doing business as
Provo Canyon School
Practice address
1350 E 750 N
North Orem Medicaid
Orem, UT 84097-4345
Phone
(801) 227-2100
NPI assigned
Aug 27, 2010
Last updated
Aug 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

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

Authorized official

Name
Dr. Jeremy Cottle, PHDNPI 1831520535
Title
Ceo
Phone
(801) 229-1036

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 126677-3902 UT Primary

Addresses

Primary practice location

1350 E 750 N
North Orem Medicaid
Orem, UT 84097-4345

Mailing address

1350 E 750 N
North Orem Medicaid
Orem, UT 84097-4345
Phone (801) 227-2100

Other identifiers 1

IdentifierTypeStateIssuer
1609843523MedicaidUT

Other names 1

  • Provo Canyon School Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Uhs Provo Canyon Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

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": "1282867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282867200000",
    "number": "1073829057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E 750 N",
            "address_2": "NORTH OREM MEDICAID",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840974345",
            "telephone_number": "801-227-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E 750 N",
            "address_2": "NORTH OREM MEDICAID",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840974345",
            "telephone_number": "801-227-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL HEALTHSERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-27",
        "last_updated": "2010-08-27",
        "status": "A",
        "authorized_official_last_name": "COTTLE",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-229-1036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "UT",
            "license": "126677-3902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609843523",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Provo Canyon School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 27, 2010; 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.