NPIMap

Organization Active NPI

University of Utah Department of OB-GYN

  • Obstetrics & Gynecology Physician
  • Salt Lake City, UT
National Provider Identifier
1265468524
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
UNIVERSITY OF UTAH DEPARTMENT OF OB-GYN
Practice address
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone
(801) 581-2719
NPI assigned
Jun 25, 2006
Last updated
Nov 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Authorized official

Name
C. Matthew Peterson, MD
Title
Department Chair
Phone
(801) 581-2719

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary
Critical Care Medicine (Obstetrics & Gynecology) Physician 207VC0200X NU
Gynecology Physician 207VG0400X NU
Obstetrics Physician 207VX0000X NU

Addresses

Primary practice location

50 N Medical Dr
Salt Lake City, UT 84132-0001

Mailing address

PO Box 413028
Salt Lake City, UT 84141-3028
Phone (801) 213-3900

Other identifiers 3

IdentifierTypeStateIssuer
003022600OtherIDIDAHO MEDICAID
100503086OtherNVNEVADA MEDICAID
121965100OtherWYWYOMING MEDICAID

National Provider Directory

National Provider Directory

Locations

675 S Arapeen Dr
#206
Salt Lake City, UT 84108
Phone (801) 585-0640

350 W 800 N
#312
Salt Lake Cty, UT 84103
Phone (801) 581-8995

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1265468524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413028",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841413028",
            "telephone_number": "801-213-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH DEPARTMENT OF OB-GYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "C. MATTHEW",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "801-581-2719",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207VC0200X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO MEDICAID",
            "identifier": "003022600",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA MEDICAID",
            "identifier": "100503086",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WYOMING MEDICAID",
            "identifier": "121965100",
            "state": "WY"
        }
    ],
    "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 Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.