George Johan Van Komen, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1558201205 Issued in UT

Practice address

2000 S 900 E
Salt Lake City, UT 84105-3208

Phone

(801) 464-7660

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD (past)
• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  NPD (past)

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1346287265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 SOUTH 1100 EAST, SUITE 204",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84102",
            "telephone_number": "801-350-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053208",
            "telephone_number": "801-464-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN KOMEN",
        "first_name": "GEORGE",
        "middle_name": "JOHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "1558201205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "942854058761",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philip James Van Hise
• Laura Kate Van Hook, LCSW
• Reed Patrick Van Hook, MD
• Kelsie Van Horn, DPT
• Kristy K. Van Katwyk, RN MSN FNP
• Van Leeuwen Dental, LLC
• Adam Richard Van Leeuwen, D.D.S.
• Nicole Van Leeuwen
• Marticia Van Leuven
• Steven Burke Van Norman, MD

• Internal Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, 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 Nov 2, 2011; 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.