NPIMap

Organization Active NPI

Peak Medical of Utah, LLC

  • Skilled Nursing Facility
  • Ogden, UT
National Provider Identifier
1366497794
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2014NCF97 Issued in UT
Legal business name
PEAK MEDICAL OF UTAH, LLC
Practice address
400 E 5350 S
Ogden, UT 84405-6931
Phone
(801) 479-9855
Fax
(801) 479-6219
NPI assigned
May 24, 2006
Organization subpart
Yes
Parent organization
PEAK MEDICAL LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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

Authorized official

Name
Steve Rothwell
Title
President Director
Phone
(505) 821-3355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2014NCF97 UT Primary

Addresses

Primary practice location

400 E 5350 S
Ogden, UT 84405-6931

Mailing address

101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604

Other identifiers 4

IdentifierTypeStateIssuer
001988010MedicaidNV
806433900MedicaidID
31118670601001OtherUTBLUE CROSS
120790300MedicaidWY

Other names 1

  • Washington Terrace Center Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452816000000",
    "number": "1366497794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SUN AVE NE",
            "address_2": "COMPLIANCE DEPARTMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094373",
            "telephone_number": "505-468-5604",
            "fax_number": "505-468-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 5350 S",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056931",
            "telephone_number": "801-479-9855",
            "fax_number": "801-479-6219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK MEDICAL OF UTAH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEAK MEDICAL LLC",
        "enumeration_date": "2006-05-24",
        "last_updated": "2016-01-15",
        "status": "A",
        "authorized_official_last_name": "ROTHWELL",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "PRESIDENT DIRECTOR",
        "authorized_official_telephone_number": "505-821-3355"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "UT",
            "license": "2014NCF97",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001988010",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806433900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "31118670601001",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120790300",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Terrace Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; 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.