NPIMap

Organization Active NPI

University of Utah Dept of OB/GYN Maternal Fetal Medicine

  • Maternal & Fetal Medicine Physician
  • Elko, NV
National Provider Identifier
1164869830
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
Legal business name
UNIVERSITY OF UTAH DEPT OF OB/GYN MATERNAL FETAL MEDICINE
Practice address
2001 Errecart Blvd
Elko, NV 89801-8333
Phone
(775) 738-5151
NPI assigned
Jun 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Authorized official

Name
Charles M Peterson, MD
Title
Department Chair
Phone
(801) 587-6470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VM0101X Primary

Addresses

Primary practice location

2001 Errecart Blvd
Elko, NV 89801-8333

Mailing address

PO Box 413028
Salt Lake City, UT 84141-3028
Phone (801) 213-3900

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370304000000",
    "number": "1164869830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413028",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841413028",
            "telephone_number": "801-213-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 ERRECART BLVD",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898018333",
            "telephone_number": "775-738-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH DEPT OF OB/GYN MATERNAL FETAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-04",
        "last_updated": "2013-06-04",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "801-587-6470",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; 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.