NPIMap

Organization Active NPI

University of Utah Adult Services

Doing business as University of Utah Rehabilitation & Wellness Program

  • Physical Medicine & Rehabilitation Physician
  • Salt Lake City, UT
National Provider Identifier
1275937146
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
UNIVERSITY OF UTAH ADULT SERVICES
Doing business as
University of Utah Rehabilitation & Wellness Program
Practice address
520 S Wakara Way
302
Salt Lake City, UT 84108-1213
Phone
(801) 581-2121
NPI assigned
Oct 21, 2014
Last updated
Oct 21, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF UTAH ADULT SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Authorized official

Name
Sean Mulvihill, MDNPI 1346330958
Title
Chief Medical Officer
Phone
(801) 587-6336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

520 S Wakara Way
302
Salt Lake City, UT 84108-1213

Mailing address

PO Box 413033
Salt Lake City, UT 84141-3033
Phone (801) 587-6336

Other names 1

  • University of Utah Rehabilitation & Wellness Program Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150209001683 UT Part B Supplier - Clinic/Group Practice 0941525273 Receives reassigned benefits from 3,021 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Sandy, UT; Salt Lake City, UT; Farmington, UT

National Provider Directory

National Provider Directory
Part of
Uni of Utah Adult Services

Locations

520 S Wakara Way
#302
Salt Lake City, UT 84108

Practitioners & affiliated clinicians

Practitioners 46

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.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413849600000",
    "number": "1275937146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413033",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841413033",
            "telephone_number": "801-587-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S WAKARA WAY",
            "address_2": "302",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081213",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-21",
        "status": "A",
        "authorized_official_last_name": "MULVIHILL",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "801-587-6336",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Utah Rehabilitation & Wellness Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.