Individual provider Active NPI

Christopher Ian Maxwell, M.D.

  • Gastroenterology Physician
  • Salt Lake City, UT
National Provider Identifier
1114107026
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
6354370-1205 Issued in UT
Practice address
1250 E 3900 S Ste 360
Salt Lake City, UT 84124-1362
Phone
(801) 263-3041
Fax
(801) 263-8485
NPI assigned
Nov 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 6354370-1205 UT
Gastroenterology Physician 207RG0100X 6354370-1205 UT Primary

Addresses

Primary practice location

1250 E 3900 S Ste 360
Salt Lake City, UT 84124-1362

Mailing address

6360 S 3000 E
#220
Salt Lake City, UT 84121-6923

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120523000070 UT Practitioner - Gastroenterology 4587827993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Kansas School of Med (KC/Wich/Sal), 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Gastroenterology LLCGroup PAC ID 9830174150, 71 clinicians

Practice addresses (Care Compare)

1187 E 3900
Salt Lake City, UT 84124-1201
Phone (801) 263-3041

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.45 of 100Reported as group
Quality
47.08
Promoting interoperability
95
Improvement activities
40
Cost
75.26

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy62
Upper gastrointestinal (GI) endoscopy for acid reflux90

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6354370-1205UTMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Gastroenterology LLC Gastroenterology CurrentSince Sep 14, 2012 Accepting new patients
Utah Gastroenterology Gastroenterology CurrentSince Sep 14, 2012 Accepting new patients
Utah Gastroenterology LLC Gastroenterology Current Accepting new patients

Locations

620 Medical Dr
Ste 205
Bountiful, UT 84010
Phone (801) 298-0057

13953 S Bangerter Pkwy
Draper, UT 84020
Phone (385) 900-4090

38 W 13775 S
Ste 100
Draper, UT 84020
Phone (801) 727-4280

5770 S 250 E
Ste 445
Salt Lake City, UT 84107
Phone (801) 314-4222

6360 S 3000 E
Ste 310
Salt Lake Cty, UT 84121
Phone (801) 944-3144

6360 S 3000 E
Ste 220
Salt Lake Cty, UT 84121
Phone (801) 944-3195

6360 S 3000 E
Ste 300
Salt Lake Cty, UT 84121
Phone (385) 900-5094

1250 E 3900 S
Ste 360
Salt Lake Cty, UT 84124
Phone (801) 262-7447

1187 E 3900 S
Salt Lake Cty, UT 84124
Phone (801) 263-3041

368 E Riverside Dr
Ste A
St George, UT 84790
Phone (435) 673-1149

Interoperability endpoints

  • FHIR API: https://4af267b3-0b17-4e37-b82c-3c19f9bce5de.gastro.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 3

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 2

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": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1114107026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 S 3000 E",
            "address_2": "#220",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S STE 360",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241362",
            "telephone_number": "801-263-3041",
            "fax_number": "801-263-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "CHRISTOPHER",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-07",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "6354370-1205",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "UT",
            "license": "6354370-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.