Organization Active NPI

Trinity Healthcare Ut, PC

Doing business as Trinity Healthcare

  • Family Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1104551043
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TRINITY HEALTHCARE UT, PC
Doing business as
Trinity Healthcare
Trinity Healthcare UT
Practice address
3720 W 800 S
Salt Lake City, UT 84104-4565
Phone
(801) 515-7266
NPI assigned
Jul 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Authorized official

Name
Dr. John Abraham, MD
Title
Owner
Phone
(417) 799-8901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3720 W 800 S
Salt Lake City, UT 84104-4565

Mailing address

2740 N Mayfair Ave
Springfield, MO 65803-5084
Phone (417) 799-8901

Other names 2

  • Trinity Healthcare Doing business as
  • Trinity Healthcare UT Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2265637Trinity Healthcare3720 W 800 S, Salt Lake City, UT 84104Certificate of waiverJul 28, 2026

National Provider Directory

National Provider Directory

Locations

3720 W 800 S
Salt Lake City, UT 84104
Phone (801) 515-7264

NPI Registry JSON

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658448000000",
    "number": "1104551043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 N MAYFAIR AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658035084",
            "telephone_number": "417-799-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 W 800 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841044565",
            "telephone_number": "801-515-7266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY HEALTHCARE UT, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-799-8901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trinity Healthcare UT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.