NPIMap

Organization Active NPI

Leo Sotiriou, MD, LLC

  • Procedural Dermatology Physician
  • Salt Lake City, UT
National Provider Identifier
1154536647
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
155029-1205 Issued in UT
Legal business name
LEO SOTIRIOU, MD, LLC
Practice address
250 East 300 South #330
Salt Lake City, UT 84111-2424
Phone
(801) 521-5630
Fax
(801) 596-9780
NPI assigned
May 10, 2007
Last updated
Jan 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Authorized official

Name
Dr. Leo Sotiriou, M.D.NPI 1801885199
Title
Physician
Phone
(801) 521-5630

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
Procedural Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207NS0135X 155029-1205 UT Primary

Addresses

Primary practice location

250 East 300 South #330
Salt Lake City, UT 84111-2424

Mailing address

250 East 300 South #330
Salt Lake City, UT 84111-2424
Phone (801) 521-5630

Other identifiers 1

IdentifierTypeStateIssuer
000057743OtherUTMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

250 E 300 S
Ste 120
Salt Lake Cty, UT 84111
Phone (801) 521-5630

250 E Broadway
Ste 330
Salt Lake Cty, UT 84111
Phone (801) 521-5630

Practitioners & affiliated clinicians

Practitioners 2

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": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1154536647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 EAST 300 SOUTH #330",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841112424",
            "telephone_number": "801-521-5630",
            "fax_number": "801-596-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 EAST 300 SOUTH #330",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841112424",
            "telephone_number": "801-521-5630",
            "fax_number": "801-596-9780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEO SOTIRIOU, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "SOTIRIOU",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "801-521-5630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "UT",
            "license": "155029-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000057743",
            "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 Jan 4, 2012; 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.