Maternal Fetal Services of Utah LLC

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

Legal business name

MATERNAL FETAL SERVICES OF UTAH LLC

Practice address

3100 Channing Way
Idaho Falls, ID 83404-7533

Phone

(208) 529-6111

Fax

(208) 529-7021

NPI assigned

Apr 11, 2007

Last updated

Nov 5, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeff Rydburg

Title

VP

Phone

(615) 373-7415

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1467675082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-529-6111",
            "fax_number": "208-529-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-529-6111",
            "fax_number": "208-529-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATERNAL FETAL SERVICES OF UTAH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "RYDBURG",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "615-373-7415"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric James Martinez
• Laura J Mason, NP
• Melanie Jean Mason, CPSS, CFSP
• Shelby Ann Mason, PTA
• Amber D Masse, NP
• Todd L Matheson, DMD
• Edward Mathews, ISAS
• Patti Mathews
• Trudy Matson
• Elizabeth Matthes

• Maternal & Fetal Medicine Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Maternal & Fetal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.