NPIMap

Individual provider Active NPI

Marie F. Couldwell

  • Endocrinology, Diabetes & Metabolism Physician
  • Salt Lake City, UT
National Provider Identifier
1083793558
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
5150808-1205 Issued in UT
Practice address
100 N Medical Dr
Salt Lake City, UT 84113-1103
Phone
(801) 581-2121
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 5150808-1205 UT Primary

Addresses

Primary practice location

100 N Medical Dr
Salt Lake City, UT 84113-1103

Mailing address

PO Box 581100
Salt Lake City, UT 84158-1100
Phone (801) 213-3800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcouldwell45852@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050216000118 UT Practitioner - EndocrinologyPractitioner - Internal Medicine 0042262214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Sep 1, 2021 Accepting new patients
University of Utah Adult Services CurrentSince Sep 1, 2021 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients
Granger Medical Specialists LLC Past Accepting new patients
Department of Pediatrics University of Utah Past Accepting new patients

Locations

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: marie.couldwell.1@16923.direct.athenahealth.com
  • Direct secure messaging: marie.couldwell.1@14863.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1083793558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 581100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841581100",
            "telephone_number": "801-213-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULDWELL",
        "first_name": "MARIE",
        "middle_name": "F.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "UT",
            "license": "5150808-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcouldwell45852@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.