NPIMap

Organization Active NPI

Lone Peak Primary Care LLC

  • Internal Medicine Physician
  • Sandy, UT
National Provider Identifier
1447360383
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LONE PEAK PRIMARY CARE LLC
Practice address
10011 Centennial Pkwy
Suite 150
Sandy, UT 84070-4156
Phone
(801) 545-8480
Fax
(801) 545-8495
NPI assigned
Aug 30, 2006
Last updated
Mar 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Authorized official

Name
David J Kane
Title
VP
Phone
(801) 568-5999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

10011 Centennial Pkwy
Suite 150
Sandy, UT 84070-4156

Mailing address

10011 Centennial Pkwy
Suite 150
Sandy, UT 84070-4156
Phone (801) 545-8480

Other identifiers 1

IdentifierTypeStateIssuer
1447360383MedicaidUT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1447360383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10011 CENTENNIAL PKWY",
            "address_2": "SUITE 150",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840704156",
            "telephone_number": "801-545-8480",
            "fax_number": "801-545-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10011 CENTENNIAL PKWY",
            "address_2": "SUITE 150",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840704156",
            "telephone_number": "801-545-8480",
            "fax_number": "801-545-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONE PEAK PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "KANE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "801-568-5999"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447360383",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.