Active NPI
John Robert Shakula, M.D.
- Pediatrics Physician
- Sandy, UT
National Provider Identifier
1235179375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 1574601205
- Practice address
- 9720 S 1300 E
W120
Sandy, UT 84094-3712 - Phone
- (801) 571-0423
- Fax
- (801) 571-0081
- NPI assigned
- Jun 7, 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 1574601205 | UT | Primary |
Addresses
Primary practice location
9720 S 1300 E
W120
Sandy, UT 84094-3712
Mailing address
12801 Boulter St
Draper, UT 84020-9134
Phone (801) 571-0423
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 |
|---|---|---|---|
| 1574601205 | UT | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1235179375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12801 BOULTER ST",
"city": "DRAPER",
"state": "UT",
"postal_code": "840209134",
"telephone_number": "801-571-0423",
"fax_number": "801-571-0081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9720 S 1300 E",
"address_2": "W120",
"city": "SANDY",
"state": "UT",
"postal_code": "840943712",
"telephone_number": "801-571-0423",
"fax_number": "801-571-0081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAKULA",
"first_name": "JOHN",
"middle_name": "ROBERT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "UT",
"license": "1574601205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.