Active NPI
David L Corwin, MD
- Child & Adolescent Psychiatry Physician
- SLC, UT
National Provider Identifier
1225147283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 3789651205
- Practice address
- 100 N Medical Dr
SLC, UT 84113-1103 - Phone
- (801) 662-3600
- Fax
- (801) 662-3610
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 3789651205 | UT | Primary |
Addresses
Primary practice location
100 N Medical Dr
SLC, UT 84113-1103
Mailing address
100 N Medical Dr
SLC, UT 84113-1103
Phone (801) 662-3600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3789651205 | UT | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Department of Pediatrics University of Utah | Past | Accepting new patients |
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.
-
- Pediatrics Physician
- Salt Lake City, UT
- NPI 1679528715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185926400000",
"number": "1225147283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N MEDICAL DR",
"city": "SLC",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-3600",
"fax_number": "801-662-3610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N MEDICAL DR",
"city": "SLC",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-3600",
"fax_number": "801-662-3610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORWIN",
"first_name": "DAVID",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "UT",
"license": "3789651205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in SLC, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.