Allegis Care-Utah, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ALLEGIS CARE-UTAH, PC

Practice address

10808 South River Road
Suite 344
South Jordan, UT 84095-6103

Phone

(773) 292-4800

Fax

(312) 564-4059

NPI assigned

Apr 13, 2012

Last updated

Sep 2, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dirk O Wales, MD

Title

Ceo/Owner

Phone

(615) 564-3511

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441152000000",
    "number": "1336406438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 S DAMEN AVE",
            "address_2": "SUITE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081169",
            "telephone_number": "773-292-4800",
            "fax_number": "312-564-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10808 SOUTH RIVER ROAD",
            "address_2": "SUITE 344",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840956103",
            "telephone_number": "773-292-4800",
            "fax_number": "312-564-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGIS CARE-UTAH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-13",
        "last_updated": "2015-09-02",
        "status": "A",
        "authorized_official_last_name": "WALES",
        "authorized_official_first_name": "DIRK",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "615-564-3511",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Internal Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; 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.