Organization Active NPI

Advanced Orthopedics and Sports Medicine

  • Specialist
  • West Jordan, UT
National Provider Identifier
1114959616
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
22772 Issued in UT
Legal business name
ADVANCED ORTHOPEDICS AND SPORTS MEDICINE
Practice address
8785 Jordan Valley Way
West Jordan, UT 84088-9772
Phone
(801) 568-3480
Fax
(801) 568-3482
NPI assigned
Jul 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Carl Johnson
Title
Clinic Manager
Phone
(801) 568-3480

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 22772 UT Primary

Addresses

Primary practice location

8785 Jordan Valley Way
West Jordan, UT 84088-9772

Mailing address

8785 Jordan Valley Way
West Jordan, UT 84088-9772
Phone (801) 568-3480

National Provider Directory

National Provider Directory

Locations

300 Hospital Dr
Ste 226
Glen Burnie, MD 21061
Phone (410) 553-8540

8785 S Jordan Valley Way
West Jordan, UT 84088
Phone (801) 568-3480

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114959616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8785 JORDAN VALLEY WAY",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889772",
            "telephone_number": "801-568-3480",
            "fax_number": "801-568-3482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8785 JORDAN VALLEY WAY",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889772",
            "telephone_number": "801-568-3480",
            "fax_number": "801-568-3482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ORTHOPEDICS AND SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "801-568-3480",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "UT",
            "license": "22772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.