Jupiter Medical I LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JUPITER MEDICAL I LLC

Practice address

1784 Uinta Way Unit E2
Park City, UT 84098-7685

Phone

(435) 604-0160

Fax

(435) 731-8328

NPI assigned

Jun 27, 2017

Last updated

Jun 27, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bryan Knepper

Title

Owner

Phone

(617) 571-3680

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Stat MD LLC

  • Urgent Care Clinic/Center
  • Park City, UT
  • NPI 1225411473

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498521600000",
    "number": "1104346543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WHITE HILL RD",
            "city": "COLD SPRING HARBOR",
            "state": "NY",
            "postal_code": "117241211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1784 UINTA WAY UNIT E2",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840987685",
            "telephone_number": "435-604-0160",
            "fax_number": "435-731-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUPITER MEDICAL I LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2017-06-27",
        "status": "A",
        "authorized_official_last_name": "KNEPPER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-571-3680",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "U000092310",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mardee Jones, NP
• Blake Nelson Jordan, PA-C
• Britta Rajamaki Joslyn, M.S., CCC-SLP
• Kate Roma Belarga Josue
• Brandon Judd, MPT
• Michael Aaron Kagen, M.D.
• Jessica Falik Kahn, MSOT
• Joanna Clarice Kahn, PT
• Alexander John Kalke, AGACNP
• Karen Stolman MD PC (Park City Dermatology, Associates)

• Internal Medicine Physician in Park City, UT
• Providers in Park City, UT by specialty
• Internal Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2017; 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.