Individual provider Active NPI

Gregory Eshima Smith, M.D.

  • Pediatric Anesthesiology Physician
  • Salt Lake City, UT
National Provider Identifier
1215293097
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
8790908-1205 Issued in UT
Practice address
100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone
(801) 662-1000
NPI assigned
Apr 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X 8790908-1205 UT Primary

Addresses

Primary practice location

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103

Mailing address

100 Mario Capecchi Dr
Department of Anesthesiology
Salt Lake City, UT 84113
Phone (801) 707-3665

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170629002466 UT Practitioner - Anesthesiology 5890914766 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8790908-1205UTMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Anesthesiologists Inc CurrentSince Aug 1, 2017 Accepting new patients

Locations

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215293097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84113",
            "telephone_number": "801-707-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GREGORY",
        "middle_name": "ESHIMA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "UT",
            "license": "8790908-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.