NPIMap

Organization Active NPI

Sunnyside Pediatrics

Doing business as Sunnyside Pediatrics, LLC

  • Primary Care Clinic/Center
  • Salt Lake City, UT
National Provider Identifier
1275940611
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SUNNYSIDE PEDIATRICS
Doing business as
Sunnyside Pediatrics, LLC
Practice address
1060 E 100 S
#400
Salt Lake City, UT 84102-1501
Phone
(801) 521-2640
Fax
(801) 363-6407
NPI assigned
Jul 17, 2014
Last updated
Jul 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Authorized official

Name
Becky Sellers
Title
Practice Administrator
Phone
(801) 526-8353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1060 E 100 S
#400
Salt Lake City, UT 84102-1501

Mailing address

1060 E 100 S
#400
Salt Lake City, UT 84102-1501
Phone (801) 521-2640

Other names 1

  • Sunnyside Pediatrics, LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1275940611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 E 100 S",
            "address_2": "#400",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021501",
            "telephone_number": "801-521-2640",
            "fax_number": "801-363-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 E 100 S",
            "address_2": "#400",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021501",
            "telephone_number": "801-521-2640",
            "fax_number": "801-363-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYSIDE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "SELLERS",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "801-526-8353"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunnyside Pediatrics, LLC",
            "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 Jul 17, 2014; 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.