NPIMap

Organization Active NPI

Primary Childrens Medical Center

  • Children's Substance Abuse Rehabilitation Facility
  • Salt Lake City, UT
National Provider Identifier
1457697369
Registry record updated Dec 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
License
2743846006 Issued in UT
Legal business name
PRIMARY CHILDRENS MEDICAL CENTER
Practice address
5770 South 1500 West
Building a
Salt Lake City, UT 84123
Phone
(801) 313-7800
NPI assigned
Dec 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2012

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

Authorized official

Name
Mr. William Thomas Kushner, SUDC
Title
Substance Abuse Counselor
Phone
(801) 313-7858

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Substance Abuse Rehabilitation Facility 3245S0500X 2743846006 UT Primary

Addresses

Primary practice location

5770 South 1500 West
Building a
Salt Lake City, UT 84123

Mailing address

5770 South 1500 West
Building a
Salt Lake City, UT 84123
Phone (801) 313-7800

National Provider Directory

National Provider Directory
Tax ID family
Bradley S Thompson DO479 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5770 S 1500 W
Bldg A
Taylorsville, UT 84123
Phone (801) 270-4509

NPI Registry JSON

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

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355961600000",
    "number": "1457697369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5770 SOUTH 1500 WEST",
            "address_2": "BUILDING A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84123",
            "telephone_number": "801-313-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 SOUTH 1500 WEST",
            "address_2": "BUILDING A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84123",
            "telephone_number": "801-313-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CHILDRENS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-20",
        "last_updated": "2012-12-20",
        "status": "A",
        "authorized_official_last_name": "KUSHNER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "SUBSTANCE ABUSE COUNSELOR",
        "authorized_official_telephone_number": "801-313-7858",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "SUDC"
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "UT",
            "license": "2743846006",
            "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 Dec 20, 2012; 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.