Organization Active NPI

Austin Med Group Inc

  • Family Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1285981852
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4859745-1265 Issued in UT
Legal business name
AUSTIN MED GROUP INC
Practice address
515 S 700 E
Salt Lake City, UT 84102-2801
Phone
(801) 343-1220
NPI assigned
Aug 13, 2012
Last updated
Sep 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Authorized official

Name
Adam Bolaft
Title
Ceo
Phone
(385) 414-4720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4859745-1265 UT Primary

Addresses

Primary practice location

515 S 700 E
Salt Lake City, UT 84102-2801

Mailing address

515 S 700 E
Salt Lake City, UT 84102-2801
Phone (801) 343-1220

National Provider Directory

National Provider Directory

Locations

515 S 700 E
Slc, UT 84102
Phone (801) 521-9403

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1285981852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S 700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022801",
            "telephone_number": "801-343-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S 700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022801",
            "telephone_number": "801-343-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN MED GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "BOLAFT",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "385-414-4720"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "4859745-1265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 18, 2012; 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.