NPIMap

Organization Active NPI

University of Utah Pediatric Surgeons

  • Pediatric Surgery Physician
  • Salt Lake City, UT
National Provider Identifier
1083623904
Registry record updated Apr 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
Legal business name
UNIVERSITY OF UTAH PEDIATRIC SURGEONS
Practice address
100 Mario Capecchi Dr
Suite 2600
Salt Lake City, UT 84113-1103
Phone
(801) 662-2950
NPI assigned
Aug 7, 2006
Last updated
Apr 14, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2009

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

Authorized official

Name
Janell I Madonna
Title
Director of Contracting and Pe
Phone
(801) 587-6464

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X
Pediatric Surgery Physician 2086S0120X Primary

Addresses

Primary practice location

100 Mario Capecchi Dr
Suite 2600
Salt Lake City, UT 84113-1103

Mailing address

100 Mario Capecchi Dr
Suite 2600
Salt Lake City, UT 84113-1103
Phone (801) 662-0250

National Provider Directory

National Provider Directory

Locations

100 N Mario Capecchi Dr
Ste 2600
Salt Lake City, UT 84113
Phone (801) 662-2950

100 N Medical Dr
#2600
Salt Lake City, UT 84112
Phone (801) 588-3350

100 N Mario Capecchi Dr
#2600
Salt Lake Cty, UT 84113
Phone (801) 662-2950

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239667200000",
    "number": "1083623904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "address_2": "SUITE 2600",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "address_2": "SUITE 2600",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-2950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH PEDIATRIC SURGEONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2009-04-14",
        "status": "A",
        "authorized_official_last_name": "MADONNA",
        "authorized_official_first_name": "JANELL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTING AND PE",
        "authorized_official_telephone_number": "801-587-6464"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "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 Apr 14, 2009; 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.