Active NPI
Gary L Hedlund, DO
- Pediatric Radiology Physician
- Salt Lake City, UT
National Provider Identifier
1154422681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Radiology Physician
- License
- 360306-1204
- Practice address
- 100 N Medical Dr
Salt Lake City, UT 84113-1103 - Phone
- (801) 662-1900
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Radiology Physician | 2085P0229X | 360306-1204 | UT | Primary |
Addresses
Primary practice location
100 N Medical Dr
Salt Lake City, UT 84113-1103
Mailing address
869 E 4500 S
PMB 511
Salt Lake City, UT 84107-3049
Phone (801) 487-0451
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1010 | Other | UT | UUHN |
| 8550895 | Other | UT | AETNA |
| 983603061000001 | Other | UT | BLUE SHIELD |
| QM0000027099 | Other | UT | ALTIUS |
| 35834 | Other | UT | DESERT MUTUAL |
| 52839 | Other | UT | PUBLIE EMPLOYEES HEALTH |
| 870355724HE1 | Other | UT | EDUCATORS MUTUAL |
| 107008669101 | Other | UT | SELECTHEALTH |
| 1600054 | Other | UT | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213660800000",
"number": "1154422681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "869 E 4500 S",
"address_2": "PMB 511",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841073049",
"telephone_number": "801-487-0451",
"fax_number": "801-487-2467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N MEDICAL DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-1900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEDLUND",
"first_name": "GARY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2008-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "UT",
"license": "360306-1204",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UUHN",
"identifier": "1010",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "8550895",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "983603061000001",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS",
"identifier": "QM0000027099",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DESERT MUTUAL",
"identifier": "35834",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PUBLIE EMPLOYEES HEALTH",
"identifier": "52839",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EDUCATORS MUTUAL",
"identifier": "870355724HE1",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELECTHEALTH",
"identifier": "107008669101",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1600054",
"state": "UT"
}
],
"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 Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.