NPIMap

Organization Active NPI

Creek Capital Anesthesia LLC

  • Dental Anesthesiology
  • Midvale, UT
National Provider Identifier
1275137663
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
Legal business name
CREEK CAPITAL ANESTHESIA LLC
Practice address
1275 E Fort Union Blvd Ste 100
Midvale, UT 84047-1890
Phone
(801) 918-4135
NPI assigned
Nov 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Authorized official

Name
Marci Nicol
Title
VP
Phone
(801) 918-4135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental AnesthesiologyGroup: 193400000X SINGLE SPECIALTY GROUP 1223D0004X Primary

Addresses

Primary practice location

1275 E Fort Union Blvd Ste 100
Midvale, UT 84047-1890

Mailing address

1275 E Fort Union Blvd Ste 100
Midvale, UT 84047-1890
Phone (801) 918-4135

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1275137663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 E FORT UNION BLVD STE 100",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471890",
            "telephone_number": "801-918-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 E FORT UNION BLVD STE 100",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471890",
            "telephone_number": "801-918-4135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEK CAPITAL ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "NICOL",
        "authorized_official_first_name": "MARCI",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "801-918-4135"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.