Deseret Medical Clinic

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5094903-1206 Issued in UT

Legal business name

DESERET MEDICAL CLINIC

Practice address

3856 W 5400 S
Suite 200
Taylorsville, UT 84118-3579

Phone

(801) 966-4600

Fax

(801) 966-3338

NPI assigned

Jul 14, 2006

Organization subpart

No

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

Authorized official

Name

Heath M Scott, PAC

Title

Owner

Phone

(801) 966-4600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275559148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "888-700-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3856 W 5400 S",
            "address_2": "SUITE 200",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841183579",
            "telephone_number": "801-966-4600",
            "fax_number": "801-966-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERET MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "HEATH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-966-4600",
        "authorized_official_credential": "PAC"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "5094903-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Demke
• Olivia Denaughel
• Samantha Denbow
• Maddilyn Dennett
• Camille Derington
• Megan Marie Destromp
• Jill Devereaux
• Shyann Devlin
• Summer Devotchka
• Steven Charles Dewey, O.D.

• Medical Physician Assistant in Taylorsville, UT
• Providers in Taylorsville, UT by specialty
• Medical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.