Active NPI
Anitha Vijayan, MD
- Nephrology Physician
- Murray, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 13327659-1205
- Practice address
- 5169 S Cottonwood St Ste 320
Murray, UT 84107-6768 - Phone
- (801) 507-2531
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 111039 | MO | |
| Nephrology Physician | 207RN0300X | 13327659-1205 | UT | Primary |
Addresses
Primary practice location
5169 S Cottonwood St Ste 320
Murray, UT 84107-6768
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other practice location 1
4921 Parkview Pl
Div IM Nephrology, Ste 5C
Saint Louis, MO 63110-1032
Phone (314) 362-7603
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 204019608 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5169 S Cottonwood St
Suite 320
Murray, UT 84107-6768
Phone (801) 507-2531
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Past | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
5169 S Cottonwood St
Ste 320
Salt Lake City, UT 84107
Phone (801) 507-2531
1490 E Foremaster Dr
Ste 350
St George, UT 84790
Phone (435) 251-5980
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
dba North Ogden Clinic - InstaCare
- Emergency Medicine Physician
- North Ogden, UT
- NPI 1033240460
-
dba St George Adolescent Partial Hospitalization
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
dba Orem Community Hospital Physicians
- Multi-Specialty Clinic/Center
- Orem, UT
- NPI 1588601124
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Intermountain Health Intermountain Medical Center
- General Acute Care Hospital
- Murray, UT
- NPI 1043220650
-
dba Intermountain Health St. George Regional Hospital
- General Acute Care Hospital
- St George, UT
- NPI 1366452880
-
dba Intermountain Health LDS Hospital
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1528078581
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697673600000",
"number": "1194741405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5169 S COTTONWOOD ST STE 320",
"city": "MURRAY",
"state": "UT",
"postal_code": "841076768",
"telephone_number": "801-507-2531"
}
],
"practiceLocations": [
{
"address_1": "4921 Parkview Pl",
"address_2": "Div IM Nephrology, Ste 5C",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631101032",
"country_code": "US",
"telephone_number": "314-362-7603",
"fax_number": "314-747-5213",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VIJAYAN",
"first_name": "ANITHA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2023-10-19",
"certification_date": "2023-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MO",
"license": "111039",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "UT",
"license": "13327659-1205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "204019608",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "4921 Parkview Pl",
"address_2": "Div IM Nephrology, Ste 5C",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631101032",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
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 Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.