NPIMap

Organization Active NPI

San Juan Public Health Special Service District

Doing business as San Juan Public Health

  • Public Health & General Preventive Medicine Physician
  • Blanding, UT
National Provider Identifier
1275050353
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
Legal business name
SAN JUAN PUBLIC HEALTH SPECIAL SERVICE DISTRICT
Doing business as
San Juan Public Health
Practice address
735 South 200 West
Suite B
Blanding, UT 84511
Phone
(435) 678-2723
Fax
(435) 678-3309
NPI assigned
Aug 29, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Kirk W Benge
Title
Director
Phone
(435) 678-2723

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X UT Primary

Addresses

Primary practice location

735 South 200 West
Suite B
Blanding, UT 84511

Mailing address

PO Box E
Blanding, UT 84511-0089
Phone (435) 678-2723

Other names 1

  • San Juan Public Health Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2127700San Juan Public Health735 S 200 W, Ste 2, Blanding, UT 84511Certificate of waiverDec 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
San Juan Public Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

735 S 200 W
Ste B
Blanding, UT 84511
Phone (435) 678-2723

NPI Registry JSON

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1275050353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX E",
            "city": "BLANDING",
            "state": "UT",
            "postal_code": "845110089",
            "telephone_number": "435-678-2723",
            "fax_number": "435-678-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 SOUTH 200 WEST",
            "address_2": "SUITE B",
            "city": "BLANDING",
            "state": "UT",
            "postal_code": "84511",
            "telephone_number": "435-678-2723",
            "fax_number": "435-678-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN PUBLIC HEALTH SPECIAL SERVICE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BENGE",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "435-678-2723",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Juan Public Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blanding, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.