NPIMap

Organization Active NPI

University of Utah Adult Services

Doing business as Cardiology - Echocardiogram

  • Multi-Specialty Clinic/Center
  • Salt Lake City, UT
National Provider Identifier
1174033989
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
UNIVERSITY OF UTAH ADULT SERVICES
Doing business as
Cardiology - Echocardiogram
Practice address
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone
(801) 585-7676
Fax
(801) 587-7290
NPI assigned
Oct 6, 2017
Last updated
May 19, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF UTAH ADULT SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Authorized official

Name
Edward B Clark, MD
Title
Department Chair
Phone
(801) 587-6336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

50 N Medical Dr
Salt Lake City, UT 84132-0001

Mailing address

PO Box 841450
Los Angeles, CA 90084-1450
Phone (801) 213-3900

Other names 1

  • Cardiology - Echocardiogram Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WY, NV3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20150209001683 UT Part B Supplier - Clinic/Group Practice 0941525273 Receives reassigned benefits from 3,021 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Sandy, UT; Salt Lake City, UT; Farmington, UT
O20150625001685 WY Part B Supplier - Clinic/Group Practice 0941525273 Receives reassigned benefits from 94 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rock Springs, WY; Jackson, WY; Evanston, WY
O20150701001557 NV Part B Supplier - Clinic/Group Practice 0941525273 Receives reassigned benefits from 29 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elko, NV; Mesquite, NV

Other NPIs on the same Medicare enrollment 28

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 28

National Provider Directory

National Provider Directory
Part of
Univ of Utah Adult Serv

Practitioners & affiliated clinicians

Practitioners 49

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.

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589846400000",
    "number": "1174033989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841450",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900841450",
            "telephone_number": "801-213-3900",
            "fax_number": "801-587-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-585-7676",
            "fax_number": "801-587-7290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "enumeration_date": "2017-10-06",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "801-587-6336",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiology - Echocardiogram",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.