Active NPI
Hendrik H. Stegall, MD
- Family Medicine Physician
- Salt Lake City, UT
National Provider Identifier
1467156802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 14164948-1205
- Practice address
- 375 S Chipeta Way Ste a
Salt Lake City, UT 84108-1261 - Phone
- (801) 581-7234
- NPI assigned
- Mar 29, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 14164948-1205 | UT | Primary |
Addresses
Primary practice location
375 S Chipeta Way Ste a
Salt Lake City, UT 84108-1261
Mailing address
375 S Chipeta Way Ste a
Salt Lake City, UT 84108-1261
Phone (801) 581-7234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241003001835 | UT | Order and Referring Only - Family Practice | 9436680295 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Ohio State University College of Medicine, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 299
Salt Lake City, UT 84110
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14164948-1205 | UT | MD | Family Medicine Physician |
Interoperability endpoints
- hendrik.stegall.1@13794.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727136000000",
"number": "1467156802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 S CHIPETA WAY STE A",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081261",
"telephone_number": "801-581-7234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 S CHIPETA WAY STE A",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081261",
"telephone_number": "801-581-7234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEGALL",
"first_name": "HENDRIK",
"middle_name": "H.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-29",
"last_updated": "2024-09-24",
"certification_date": "2024-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "UT",
"license": "14164948-1205",
"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 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.