NPIMap

Organization Active NPI

University of Utah Adult Services

Doing business as MEMORIAL HOSPITAL SWEETWATER-Vascular Lab

  • Vascular Surgery Physician
  • Rock Springs, WY
National Provider Identifier
1104204361
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
UNIVERSITY OF UTAH ADULT SERVICES
Doing business as
MEMORIAL HOSPITAL SWEETWATER-Vascular Lab
Practice address
1200 College Dr
Rock Springs, WY 82901-5868
Phone
(801) 581-2121
NPI assigned
May 8, 2015
Last updated
Jan 22, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF UTAH ADULT SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Authorized official

Name
Dr. Samuel Finlayson, MD
Title
Chief Clinical Officer
Phone
(801) 587-6336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X NU Primary

Addresses

Primary practice location

1200 College Dr
Rock Springs, WY 82901-5868

Mailing address

PO Box 841450
Los Angeles, CA 90084-1450

Other names 1

  • MEMORIAL HOSPITAL SWEETWATER-Vascular Lab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150625001685 WY Part B Supplier - Clinic/Group Practice 0941525273 Receives reassigned benefits from 94 practitioners
18 other NPIs on this enrollment
Practice locations: Rock Springs, WY; Jackson, WY; Evanston, WY

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

National Provider Directory

National Provider Directory
Part of
Univ of Utah Adult Serv

Practitioners & affiliated clinicians

Practitioners 98

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 98

NPI Registry JSON

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1104204361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841450",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900841450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 COLLEGE DR",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015868",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "enumeration_date": "2015-05-08",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "FINLAYSON",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "801-587-6336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEMORIAL HOSPITAL SWEETWATER-Vascular Lab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEMORIAL HOSPITAL SWEETWATER-Vascular Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rock Springs, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.