Individual provider Active NPI

Matthew C Vukin, M.D.

  • Psychiatry Physician
  • Salt Lake City, UT
National Provider Identifier
1114052248
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
6353510-1205 Issued in UT
Practice address
University of Utah Department of Psychiatry
50 North Medical Drive
Salt Lake City, UT 84132-0001
Phone
(801) 574-7142
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 6353510-1205 UT Primary

Addresses

Primary practice location

University of Utah Department of Psychiatry
50 North Medical Drive
Salt Lake City, UT 84132-0001

Mailing address

University of Utah Department of Psychiatry
50 North Medical Drive
Salt Lake City, UT 84132-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6353510-1205UTMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114052248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF UTAH DEPARTMENT OF PSYCHIATRY",
            "address_2": "50 NORTH MEDICAL DRIVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF UTAH DEPARTMENT OF PSYCHIATRY",
            "address_2": "50 NORTH MEDICAL DRIVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-574-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VUKIN",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "6353510-1205",
            "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 Jul 8, 2007; 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.