Organization Active NPI

Hope Family Medical Center LLC

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1134570328
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2231894405 Issued in UT
Legal business name
HOPE FAMILY MEDICAL CENTER LLC
Practice address
166 E 5900 S Ste B109
Salt Lake City, UT 84107-7293
Phone
(385) 275-4673
NPI assigned
Jun 28, 2016
Organization subpart
Yes
Parent organization
HOPE FAMILY MEDICAL CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Authorized official

Name
Geraldine Jody Stubler, FNP-CNPI 1861892861
Title
Medical Director
Phone
(385) 275-4673

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 2231894405 UT Primary

Addresses

Primary practice location

166 E 5900 S Ste B109
Salt Lake City, UT 84107-7293

Mailing address

166 E 5900 S Ste B109
Salt Lake City, UT 84107-7293
Phone (385) 275-4673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170201001263 UT Part B Supplier - Clinic/Group Practice 4385927185 Receives reassigned benefits from 3 practitioners
Practice locations: Salt Lake City, UT

National Provider Directory

National Provider Directory
Part of
Hope Family Medical Center

Locations

166 E 5900 S
Salt Lake City, UT 84107
Phone (801) 266-1412

166 E 5900 S
Ste B109
Salt Lake Cty, UT 84107
Phone (385) 275-4673

1345 E 3900 S
Ste 204
Slc, UT 84124
Phone (385) 275-4673

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1134570328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 E 5900 S STE B109",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841077293",
            "telephone_number": "385-275-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 E 5900 S STE B109",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841077293",
            "telephone_number": "385-275-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPE FAMILY MEDICAL CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOPE FAMILY MEDICAL CENTER LLC",
        "enumeration_date": "2016-06-28",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "STUBLER",
        "authorized_official_first_name": "GERALDINE",
        "authorized_official_middle_name": "JODY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "385-275-4673",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "2231894405",
            "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 Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.