NPIMap

Organization Active NPI

University of Utah Healthcare

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Salt Lake City, UT
National Provider Identifier
1235546573
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
13644 Issued in UT
Legal business name
UNIVERSITY OF UTAH HEALTHCARE
Practice address
51 W 3900 S
Salt Lake City, UT 84107-1431
Phone
(801) 587-2370
Fax
(801) 266-1088
NPI assigned
Jul 18, 2014
Last updated
Mar 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2017

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

Authorized official

Name
Ross Van Vranken
Title
Executive Director
Phone
(801) 587-3115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 13644 UT Primary

Addresses

Primary practice location

51 W 3900 S
Salt Lake City, UT 84107-1431

Mailing address

51 W 3900 S
Salt Lake City, UT 84107-1431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050629000441 UT Part B Supplier - Clinic/Group Practice 0749262665 Receives reassigned benefits from 144 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salt Lake City, UT

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
University of Utah Heal73 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 36

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 36

NPI Registry JSON

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488499200000",
    "number": "1235546573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 W 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841071431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 W 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841071431",
            "telephone_number": "801-587-2370",
            "fax_number": "801-266-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-18",
        "last_updated": "2017-03-03",
        "status": "A",
        "authorized_official_last_name": "VAN VRANKEN",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-587-3115"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "UT",
            "license": "13644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 3, 2017; 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.