NPIMap

Organization Active NPI

Physician Group of Utah Inc

  • Cardiovascular Disease Physician
  • Murray, UT
National Provider Identifier
1154883668
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
PHYSICIAN GROUP OF UTAH INC
Practice address
5979 S 300 E
Murray, UT 84107-7364
Phone
(801) 263-2370
Fax
(801) 265-1200
NPI assigned
Apr 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Authorized official

Name
Tyler K Wilko
Title
Ceo
Phone
(801) 984-3293

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X

Addresses

Primary practice location

5979 S 300 E
Murray, UT 84107-7364

Mailing address

PO Box 281415
Atlanta, GA 30384-1415
Phone (800) 673-1270

Other names 1

  • STEWARD MEDICAL GROUP OF UTAH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Physician Group of Utah Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554249600000",
    "number": "1154883668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 281415",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841415",
            "telephone_number": "800-673-1270",
            "fax_number": "314-432-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 S 300 E",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077364",
            "telephone_number": "801-263-2370",
            "fax_number": "801-265-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN GROUP OF UTAH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-03",
        "last_updated": "2019-04-03",
        "status": "A",
        "authorized_official_last_name": "WILKO",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-984-3293"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STEWARD MEDICAL GROUP OF UTAH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.