Shriners Hospitals for Children

Primary specialty

Children's HospitalTaxonomy code 282NC2000X

License

2005-HOSP-2006 Issued in UT

Legal business name

SHRINERS HOSPITALS FOR CHILDREN

Practice address

1275 Fairfax Rd
Salt Lake City, UT 84103-4324

Phone

(801) 536-3714

Fax

(801) 536-3799

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Kevin Craig Martin

Title

Hospital Administrator

Phone

(801) 536-3700

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 463302

Legal name

SHRINERS HOSPITALS FOR CHILDREN - SALT LAKE CITY

Certification status

Terminated Voluntary: merger or closure, Aug 31, 2021

Provider type (POS)

Hospital – Children’s

Participating since

Oct 21, 2010

Last certification

Oct 24, 2013

Beds

45

Ownership / control type

Private (not for profit)

Facility address

1275 East Fairfax Road
Salt Lake City, UT 84103

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Shriners Hospitals for Children

  • Children's Hospital
  • Honolulu, HI
  • NPI 1316065360

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cynthia Van Nguyen, MD

  • Pediatric Orthopaedic Surgery Physician
  • Pasadena, CA
  • NPI 1568756468
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1255461075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SHRINERS HOSPITAL FOR CHILDREN SALT",
            "address_2": "P.O. BOX 8500 LOCKBOX #7462",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191787642",
            "telephone_number": "801-536-3714",
            "fax_number": "801-536-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 FAIRFAX RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841034324",
            "telephone_number": "801-536-3714",
            "fax_number": "801-536-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHRINERS HOSPITALS FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "HOSPITAL ADMINISTRATOR",
        "authorized_official_telephone_number": "801-536-3700"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "UT",
            "license": "2005-HOSP-2006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE FACILITY LICENSE",
            "identifier": "2005-HOSP-206",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myranda A Shrestha
• Melissa Shrewsbury, CMHC
• Michael Byard Shrewsbury
• Dennis C Shrieve, M.D.
• Shriners Hospitals for Children
• Shriners Hospitals for Children
• Shriners Hospitals for Children
• Shrinkster, LLC
• Shroy Healthcare Pharmaceuticals Inc
• Amy Shuckra, DPT

• Children's Hospital in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Children's Hospital in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.