NPIMap

Organization Active NPI

Ageless Men's Health Holdings, Inc

Doing business as Ageless Men's Health

  • Family Medicine Physician
  • Marriott Slaterville, UT
National Provider Identifier
1376257386
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AGELESS MEN'S HEALTH HOLDINGS, INC
Doing business as
Ageless Men's Health
Practice address
1920 W 250 N Ste 1
Marriott Slaterville, UT 84404-9234
Phone
(801) 878-7411
NPI assigned
Jan 13, 2023
Last updated
Nov 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Amanda Wilkinson
Title
Business Operations Manager
Phone
(702) 818-0446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1920 W 250 N Ste 1
Marriott Slaterville, UT 84404-9234

Mailing address

1920 W 250 N Ste 1
Marriott Slaterville, UT 84404-9234

Other names 1

  • Ageless Men's Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ageless Men's Health Holdings LLC18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

1920 W 250 N
Ste 1
Marriott Slaterville, UT 84404
Phone (801) 689-2647

NPI Registry JSON

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1376257386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 W 250 N STE 1",
            "city": "MARRIOTT SLATERVILLE",
            "state": "UT",
            "postal_code": "844049234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 W 250 N STE 1",
            "city": "MARRIOTT SLATERVILLE",
            "state": "UT",
            "postal_code": "844049234",
            "telephone_number": "801-878-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS MEN'S HEALTH HOLDINGS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-13",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BUSINESS OPERATIONS MANAGER",
        "authorized_official_telephone_number": "702-818-0446"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ageless Men's Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ageless Men's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marriott Slaterville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.