NPIMap

Organization Active NPI

Western Neurological Associates Inc

  • Neurology Physician
  • Salt Lake City, UT
National Provider Identifier
1083611966
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
WESTERN NEUROLOGICAL ASSOCIATES INC
Practice address
1151 E 3900 S
#B150
Salt Lake City, UT 84124-1216
Phone
(801) 262-3441
Fax
(801) 269-9005
NPI assigned
Jul 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Michelle Lynn Hines
Title
Business Office
Phone
(801) 262-3441

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X UT Primary
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0402X UT
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X 0055926 UT

Addresses

Primary practice location

1151 E 3900 S
#B150
Salt Lake City, UT 84124-1216

Mailing address

1151 E 3900 S
#B150
Salt Lake City, UT 84124-1216
Phone (801) 262-3441

Other identifiers 2

IdentifierTypeStateIssuer
870446965007MedicaidUT
00055926OtherUTMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

1151 E 3900 S
Ste B150
Slc, UT 84124
Phone (801) 262-3441

Practitioners & affiliated clinicians

Practitioners 9

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": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1083611966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 E 3900 S",
            "address_2": "#B150",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241216",
            "telephone_number": "801-262-3441",
            "fax_number": "801-269-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 E 3900 S",
            "address_2": "#B150",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241216",
            "telephone_number": "801-262-3441",
            "fax_number": "801-269-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN NEUROLOGICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "BUSINESS OFFICE",
        "authorized_official_telephone_number": "801-262-3441"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "UT",
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "UT",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "0055926",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870446965007",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00055926",
            "state": "UT"
        }
    ],
    "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 Jul 21, 2022; 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.