Intermountain Cardiovascular Assoc.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

162213-1205 Issued in UT

Legal business name

INTERMOUNTAIN CARDIOVASCULAR ASSOC.

Practice address

370 9TH Ave
Suite 208
Salt Lake City, UT 84103-2877

Phone

(801) 408-2260

Fax

(801) 408-5236

NPI assigned

Sep 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael P. Collins, M.D.

Title

Cardiothoracic Surgeon

Phone

(801) 408-2260

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1487841987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 9TH AVE",
            "address_2": "SUITE 208",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032877",
            "telephone_number": "801-408-2260",
            "fax_number": "801-408-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 9TH AVE",
            "address_2": "SUITE 208",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032877",
            "telephone_number": "801-408-2260",
            "fax_number": "801-408-5236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN CARDIOVASCULAR ASSOC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CARDIOTHORACIC SURGEON",
        "authorized_official_telephone_number": "801-408-2260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "UT",
            "license": "162213-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.