Individual provider Active NPI

David Scott Gourley, M.D.

  • Allergy & Immunology Physician
  • Murray, UT
National Provider Identifier
1477555712
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
90-183859-1205 Issued in UT
Practice address
6065 S Fashion Blvd
Ste 255
Murray, UT 84107-7381
Phone
(801) 266-4115
Fax
(801) 266-4138
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 90-183859-1205 UT Primary

Addresses

Primary practice location

6065 S Fashion Blvd
Ste 255
Murray, UT 84107-7381

Mailing address

1660 W Antelope Dr
Ste 225
Layton, UT 84041-1156
Phone (801) 775-9800

Other identifiers 2

IdentifierTypeStateIssuer
030001480OtherRAILROAD MEDICARE
1838591205OtherUTUT PROFESSIONAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
90-183859-1205UTMDAllergy & Immunology Physician

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1477555712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 W ANTELOPE DR",
            "address_2": "STE 225",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411156",
            "telephone_number": "801-775-9800",
            "fax_number": "801-775-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6065 S FASHION BLVD",
            "address_2": "STE 255",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077381",
            "telephone_number": "801-266-4115",
            "fax_number": "801-266-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURLEY",
        "first_name": "DAVID",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "UT",
            "license": "90-183859-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "030001480",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UT PROFESSIONAL LICENSE",
            "identifier": "1838591205",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.