Utah Gastroenterology
Organization Active NPI Gastroenterology Physician · Sandy, UT
NPI 1124837646 · NPPES record last updated Dec 31, 2024
Key facts
- NPI
- 1124837646
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- Legal business name
- UTAH GASTROENTEROLOGY
- Practice address
- 10150 S Petunia Way Ste B
Sandy, UT 84092-4328 - Phone
- (801) 619-9000
- NPI assigned
- Dec 31, 2024
- Organization subpart
- No
Authorized official
- Name
- Christine Morris Gabrenas
- Title
- Administrator
- Phone
- (801) 944-3191
Other NPIs on the same Medicare enrollment 7
Corporate family (same tax ID) 2
Practitioners 82
-
Miquela Afshar, CRNA
-
Tyson Amundsen, MD
-
J Todd Baker, CRNA
-
Robert Kyle Barnett, M.D.
-
Jeffrey Logan Bell, CRNA
-
Mark E Boschert, M.D.
-
Emily Chipping, CRNA
-
Jeffrey Lyle Christensen, CRNA
-
Michael D Cragun, CRNA
-
Daniel Cruttenden, CRNA
-
Scott Diamond, DO
-
Brett W Doxey, MD
-
Peter C. O. Fenton, M.D.
-
Charlie W. Fox, MD
-
Edward J Frech, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040621001991 | UT | Part B Supplier - Clinic/Group Practice | 9830174150 |
Receives reassigned benefits from 88 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bountiful, UT; Draper, UT; Lehi, UT; Salt Lake City, UT; Sandy, UT; St George, UT |
National Provider Directory
- Tax ID family
- Mountain West Gastroent
Locations
520 Medical Dr
Ste 200
Bountiful, UT 84010
Phone (801) 292-4400
13953 S Bangerter Pkwy
Draper, UT 84020
Phone (385) 900-4090
3000 N Triumph Blvd
Ste 340
Lehi, UT 84043
Phone (435) 833-9180
3741 W 12600 S
#420
Riverton, UT 84065
Phone (801) 727-4280
Interoperability endpoints
- https://4af267b3-0b17-4e37-b82c-3c19f9bce5de.gastro.prod.fhir.ema-api.com/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician |
207RG0100X | Yes |
Addresses
Primary practice location
10150 S Petunia Way Ste B
Sandy, UT 84092-4328
Mailing address
1187 E 3900 S
Salt Lake City, UT 84124-1201
Other providers in Sandy, UT
- Utah Behavioral Health Services, LLC
- Utah Center for Medical Weight Loss, LLC
- Utah CVS Pharmacy LLC
- Utah CVS Pharmacy LLC
- Utah CVS Pharmacy, LLC
- Utah Gastroenterology, LLC
- Utah Infectious Disease
- Utah Kids First
- Utah Medical Hearing Centers Foothill
- Utah Mobile NP Consulting LLC
All providers in Sandy, UT · Gastroenterology Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.