NPIMap

Organization Active NPI

Intermountain Healthcare

  • Children's Hospital
  • Salt Lake City, UT
National Provider Identifier
1154508653
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
License
218983-4405 Issued in UT
Legal business name
INTERMOUNTAIN HEALTHCARE
Practice address
100 N Medical Dr
PCMC
Salt Lake City, UT 84113-1103
Phone
(801) 662-2442
Fax
(801) 662-2469
NPI assigned
Jan 28, 2008
Last updated
Jan 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Authorized official

Name
Donald Vernon, MDNPI 1982783551
Title
Medical Director, Ped Crit Care
Phone
(801) 662-2427

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Hospital 282NC2000X 218983-4405 UT Primary

Addresses

Primary practice location

100 N Medical Dr
PCMC
Salt Lake City, UT 84113-1103

Mailing address

100 N Medical Dr
PCMC
Salt Lake City, UT 84113-1103
Phone (801) 662-2442

Other names 1

  • Primary Children's Medical Center Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1154508653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N MEDICAL DR",
            "address_2": "PCMC",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-2442",
            "fax_number": "801-662-2469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MEDICAL DR",
            "address_2": "PCMC",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-2442",
            "fax_number": "801-662-2469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "VERNON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR, PED CRIT CARE",
        "authorized_official_telephone_number": "801-662-2427",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "UT",
            "license": "218983-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Children's Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 28, 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.

Verify at the official NPI Registry.