NPIMap

Organization Active NPI

Copperview Medical Center, LLC

  • Family Medicine Physician
  • South Jordan, UT
National Provider Identifier
1316970924
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COPPERVIEW MEDICAL CENTER, LLC
Practice address
3556 W 9800 S Ste 101
South Jordan, UT 84095-3221
Phone
(801) 567-9780
Fax
(801) 567-9826
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Authorized official

Name
Paul Lei
Title
Authorized Official
Phone
(801) 260-1919

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

3556 W 9800 S Ste 101
South Jordan, UT 84095-3221

Mailing address

3556 W 9800 S Ste 101
South Jordan, UT 84095-3221

Other practice location 1

12842 S 3600 W Ste 102
Riverton, UT 84065-6853
Phone (801) 567-9780

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031124000640 UT Part B Supplier - Clinic/Group Practice 4284538976 Receives reassigned benefits from 39 practitioners
Practice locations: Riverton, UT; South Jordan, UT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D0989936Copperview Medical Center3556 W 9800 S #101, S Jordan, UT 84095Provider-performed microscopyJul 21, 2028
46D2276088Copperview Medical Center Riverton12842 S 3600 W, Ste 201, Riverton, UT 84065Certificate of waiverFeb 1, 2027

National Provider Directory

National Provider Directory

Locations

12842 S 3600 W
Ste 102
Riverton, UT 84065
Phone (801) 567-9780

12842 S 3600 W
Riverton, UT 84065

3556 W 9800 S
South Jordan, UT 84095
Phone (801) 567-9780

Practitioners & affiliated clinicians

Practitioners 40

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 40

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679011200000",
    "number": "1316970924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3556 W 9800 S STE 101",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840953221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3556 W 9800 S STE 101",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840953221",
            "telephone_number": "801-567-9780",
            "fax_number": "801-567-9826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12842 S 3600 W Ste 102",
            "address_purpose": "LOCATION",
            "city": "Riverton",
            "state": "UT",
            "postal_code": "840656853",
            "country_code": "US",
            "telephone_number": "801-567-9780",
            "fax_number": "801-567-9826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COPPERVIEW MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A",
        "authorized_official_last_name": "LEI",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "801-260-1919"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.