Active NPI
Cottonwood OB-GYN
- Obstetrics & Gynecology Physician
- Murray, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- Legal business name
- COTTONWOOD OB-GYN
- Practice address
- 5063 S Cottonwood St Ste 400
Murray, UT 84107 - Phone
- (801) 507-1950
- Fax
- (801) 507-1951
- NPI assigned
- Feb 8, 2016
- Last updated
- Jul 31, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Steven M Thackeray, M.D.
- Title
- Partner
- Phone
- (801) 507-1950
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | Primary |
Addresses
Primary practice location
5063 S Cottonwood St Ste 400
Murray, UT 84107
Mailing address
5063 S Cottonwood St Ste 400
Murray, UT 84107-6773
Phone (801) 507-1950
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 46D0523876 | Cottonwood OB GYN | Provider-performed microscopy | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
291 W 5400 S
Salt Lake City, UT 84107
Phone (385) 758-1920
5063 S Cottonwood St
Ste 400
Salt Lake City, UT 84107
Phone (801) 507-1850
Practitioners & affiliated clinicians
Practitioners 12
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Obstetrics & Gynecology Physician
- Murray, UT
- NPI 1407813959
-
- Obstetrics & Gynecology Physician
- Salt Lake City, UT
- NPI 1972644821
-
- Obstetrics & Gynecology Physician
- Salt Lake City, UT
- NPI 1689849523
-
- Obstetrics & Gynecology Physician
- Murray, UT
- NPI 1538117965
-
- Obstetrics & Gynecology Physician
- Murray, UT
- NPI 1376833046
-
- Obstetrics & Gynecology Physician
- Taylorsville, UT
- NPI 1376656264
-
- Obstetrics & Gynecology Physician
- Murray, UT
- NPI 1699119487
-
- Obstetrics & Gynecology Physician
- Murray, UT
- NPI 1679192215
-
- Obstetrics & Gynecology Physician
- Port Angeles, WA
- NPI 1063075612
-
- Obstetrics & Gynecology Physician
- Murray, UT
- NPI 1730137571
-
- Family Nurse Practitioner
- Lehi, UT
- NPI 1326107764
-
- Obstetrics & Gynecology Physician
- Murray, UT
- NPI 1457309213
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454889600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1532995200000",
"number": "1417315243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5063 S COTTONWOOD ST STE 400",
"city": "MURRAY",
"state": "UT",
"postal_code": "841076773",
"telephone_number": "801-507-1950",
"fax_number": "801-507-1951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5063 S COTTONWOOD ST STE 400",
"city": "MURRAY",
"state": "UT",
"postal_code": "84107",
"telephone_number": "801-507-1950",
"fax_number": "801-507-1951"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COTTONWOOD OB-GYN",
"organizational_subpart": "NO",
"enumeration_date": "2016-02-08",
"last_updated": "2018-07-31",
"status": "A",
"authorized_official_last_name": "THACKERAY",
"authorized_official_first_name": "STEVEN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "801-507-1950",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.