NPIMap

Organization Active NPI

Pediatric Anesthesiologists Inc

  • Anesthesiology Physician
  • Salt Lake City, UT
National Provider Identifier
1417965799
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PEDIATRIC ANESTHESIOLOGISTS INC
Practice address
100 N Medical Dr
Salt Lake City, UT 84113-1103
Phone
(888) 249-4598
Fax
(801) 432-2670
NPI assigned
Aug 3, 2006
Last updated
Sep 14, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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

Authorized official

Name
W. Curtis Peterson, MD
Title
President
Phone
(888) 249-4598

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

100 N Medical Dr
Salt Lake City, UT 84113-1103

Mailing address

PO Box 3870
Salt Lake City, UT 84110-3870
Phone (888) 249-4598

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040824000152 UT Part B Supplier - Clinic/Group Practice 4385618578 Receives reassigned benefits from 49 practitioners
Practice locations: Salt Lake City, UT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 50

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.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1417965799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3870",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103870",
            "telephone_number": "888-249-4598",
            "fax_number": "801-432-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "888-249-4598",
            "fax_number": "801-432-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ANESTHESIOLOGISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "W. CURTIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-249-4598",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.