NPIMap

Organization Active NPI

Southwest Children's Clinic

  • Specialist
  • West Jordan, UT
National Provider Identifier
1144345737
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
319791-1205 Issued in UT
Legal business name
SOUTHWEST CHILDREN'S CLINIC
Practice address
8822 So Redwood Rd
C211
West Jordan, UT 84088-8811
Phone
(801) 563-1975
Fax
(801) 563-1984
NPI assigned
Mar 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Mrs. Jill Phillips
Title
Office Manager
Phone
(801) 593-1975

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 319791-1205 UT Primary

Addresses

Primary practice location

8822 So Redwood Rd
C211
West Jordan, UT 84088-8811

Mailing address

8822 Redwood Rd Ste C211
West Jordan, UT 84088-9336
Phone (801) 563-1975

Other identifiers 4

IdentifierTypeStateIssuer
D1713MedicaidUT
07027MedicaidUT
D5092MedicaidUT
D3859MedicaidUT

National Provider Directory

National Provider Directory

Locations

8822 S Redwood Rd
Ste C211
West Jordan, UT 84088
Phone (801) 563-1975

Practitioners & affiliated clinicians

Practitioners 12

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": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144345737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8822 REDWOOD RD STE C211",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889336",
            "telephone_number": "801-563-1975",
            "fax_number": "801-563-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8822 SO REDWOOD RD",
            "address_2": "C211",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840888811",
            "telephone_number": "801-563-1975",
            "fax_number": "801-563-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST CHILDREN'S CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-593-1975",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "319791-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D1713",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07027",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D5092",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D3859",
            "state": "UT"
        }
    ],
    "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.