Physician Home Care of Utah,L.C.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

169963-1205 Issued in UT

Legal business name

PHYSICIAN HOME CARE OF UTAH,L.C.

Practice address

6886 Hollow Mill Dr
Salt Lake City, UT 84121-3322

Phone

(801) 944-0095

NPI assigned

Sep 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John R Dietlein, M.D.

Title

Medical Director

Phone

(801) 944-0095

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

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

• Laura Chamberlain, NP-C

  • Family Nurse Practitioner
  • Murray, UT
  • NPI 1164727335
  NPD (past)
• Sarah Jean Goodlin, M.D

  • Internal Medicine Physician
  • Salt Lake City, UT
  • NPI 1841227865
  NPD (past)
• Sharon A. Strong, MD

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1053343566
  NPD (past)

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1326148073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 712270",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841712270",
            "telephone_number": "801-944-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6886 HOLLOW MILL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841213322",
            "telephone_number": "801-944-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN HOME CARE OF UTAH,L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-23",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "DIETLEIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "801-944-0095",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "UT",
            "license": "169963-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "530429522033",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phoenix Rising Treatment, LLC.
• Kanlayanee Phothiworn
• Tenzin Kunsang Phunrab, APRN
• Physical Medicine and Rehabilitation Utah PLLC
• Physical Therapy and Sports
• Physician House Calls, Inc.
• Physician Management Services of Utah II, LLC
• Physician Specialty Care of Utah (Solstice Medical Group)
• Physician Wound Care Specialists of Utah
• Physicians Laser Center

• Geriatric Medicine (Family Medicine) Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Geriatric Medicine (Family Medicine) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; 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.