NPIMap

University of Utah Plastic Surgery Associates

Organization Active NPI Plastic Surgery Physician · Salt Lake City, UT

NPI 1326057258 · NPPES record last updated Apr 14, 2009

Key facts

NPI
1326057258
Entity type
Organization (NPI type 2)
Primary specialty
Plastic Surgery Physician 208200000X
Legal business name
UNIVERSITY OF UTAH PLASTIC SURGERY ASSOCIATES
Practice address
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone
(801) 581-2121
NPI assigned
Aug 7, 2006
Organization subpart
No

Authorized official

Name
Janell I Madonna
Title
Director of Contracting and Pe
Phone
(801) 587-6464

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

30 N 1900 E
Rm 3B205
Salt Lake Cty, UT 84132
Phone (801) 581-7073

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208200000X Yes
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2082S0099X
Surgery of the Hand (Plastic Surgery) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2082S0105X
Surgical Critical Care Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2086S0102X
Surgery of the Hand (Surgery) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2086S0105X
Plastic and Reconstructive Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2086S0122X

Addresses

Primary practice location

50 N Medical Dr
Salt Lake City, UT 84132-0001

Mailing address

PO Box 58049
Salt Lake City, UT 84158-0049
Phone (801) 581-7073

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 14, 2009.

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239667200000",
    "number": "1326057258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58049",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841580049",
            "telephone_number": "801-581-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH PLASTIC SURGERY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2009-04-14",
        "status": "A",
        "authorized_official_last_name": "MADONNA",
        "authorized_official_first_name": "JANELL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTING AND PE",
        "authorized_official_telephone_number": "801-587-6464"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Critical Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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Sources for this page

Verify at the official NPI Registry.