Individual provider Active NPI

Christine Chen, MD

  • Anesthesiology Physician
  • Salt Lake City, UT
National Provider Identifier
1295840247
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4919058-1205 Issued in UT
Practice address
100 N Medical Dr
Salt Lake City, UT 84113-1103
Phone
(801) 993-9551
Fax
(801) 733-5872
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4919058-1205 UT Primary

Addresses

Primary practice location

100 N Medical Dr
Salt Lake City, UT 84113-1103

Mailing address

1608 Sunset Oaks Dr
Salt Lake City, UT 84108-2848
Phone (801) 582-9493

Other identifiers 9

IdentifierTypeStateIssuer
489642MedicaidAZ
107009154102OtherUTIHC
690869OtherUTDESERET MUTUAL
PRA05746OtherUTMOLINA
401765MedicaidMT
93492OtherUTHEALTHY U
2000395OtherUTUNITED HEALTHCARE
64594OtherUTPEHP
QM0000051257OtherUTALTIUS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040824000182 UT Practitioner - Anesthesiology 4688648876 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4919058-1205UTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Surgical Suite Current Accepting new patients
Family Surgical Suite Anesthesiology CurrentSince Nov 28, 2023 Accepting new patients
Pediatric Anesthesiologists Inc Anesthesiology CurrentSince Jun 10, 2010 Accepting new patients

Locations

151 E 5600 S
Ste 100
Salt Lake City, UT 84107
Phone (801) 833-0449

151 E 5600 S
Ste 104
Salt Lake Cty, UT 84107
Phone (801) 816-0332

100 N Medical Dr
Slc, UT 84112
Phone (801) 581-7877

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

8822 S Redwood Rd
Ste C113
West Jordan, UT 84088
Phone (801) 285-7052

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295840247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 SUNSET OAKS DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841082848",
            "telephone_number": "801-582-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-993-9551",
            "fax_number": "801-733-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "CHRISTINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "4919058-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "489642",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC",
            "identifier": "107009154102",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL",
            "identifier": "690869",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "PRA05746",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401765",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY U",
            "identifier": "93492",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2000395",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "64594",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "QM0000051257",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.