Active NPI
Alyson Elaine Edmunds, MD
- Pediatrics Physician
- Salt Lake City, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 344720-1205
- Practice address
- 100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103 - Phone
- (801) 662-3645
- NPI assigned
- Jun 29, 2007
- Last updated
- Nov 3, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 0116019749 | VA | |
| Emergency Medicine Physician | 207P00000X | 0101246455 | VA | |
| Pediatrics Physician | 208000000X | 344720-1205 | UT | Primary |
Addresses
Primary practice location
100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Mailing address
PO Box 413021
Salt Lake City, UT 84141-3021
Phone (801) 213-3900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306043682 | Medicaid | VA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101246455 | VA | MD | Emergency Medicine Physician |
| 0116019749 | VA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Pediatrics | Current | Accepting new patients |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Past | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
3741 W 12600 S
Riverton, UT 84065
Phone (801) 285-2400
9450 S 1300 E
Sandy, UT 84094
Phone (801) 501-2133
9450 S 1300 E
Ste 210
Sandy, UT 84094
Phone (801) 501-4305
100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109
1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992
1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba IMED Physicians Billing
- Multi-Specialty Clinic/Center
- Murray, UT
- NPI 1629260880
Pediatrics
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
dba LDS Hospital Physicians
- Multi-Specialty Clinic/Center
- Salt Lake City, UT
- NPI 1699795831
-
dba St George Adolescent Partial Hospitalization
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
dba Southwest Rheumatology Associates
- Rheumatology Physician
- St George, UT
- NPI 1093246720
-
dba Orem Community Hospital Physicians
- Multi-Specialty Clinic/Center
- Orem, UT
- NPI 1588601124
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414972800000",
"number": "1306043682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 413021",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841413021",
"telephone_number": "801-213-3900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-3645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMUNDS",
"first_name": "ALYSON",
"middle_name": "ELAINE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-29",
"last_updated": "2014-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "VA",
"license": "0116019749",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "VA",
"license": "0101246455",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "UT",
"license": "344720-1205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306043682",
"state": "VA"
}
],
"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 Nov 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.