Edwin Clifford McGough, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

154013-1205 Issued in UT

Practice address

705 N Pioneer Fork Rd
Salt Lake City, UT 84108-1642

Phone

(801) 554-9481

NPI assigned

Feb 26, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401148800000",
    "number": "1487994562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 N PIONEER FORK RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081642",
            "telephone_number": "801-554-9481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 N PIONEER FORK RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081642",
            "telephone_number": "801-554-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOUGH",
        "first_name": "EDWIN",
        "middle_name": "CLIFFORD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-26",
        "last_updated": "2014-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "UT",
            "license": "154013-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camille McGillis, LCMHC
• Gregory McGinn, D.C.
• Shannon Claire McGirk
• Erin Catherine McGlade, PHD
• Keith McGoldrick, PH.D.
• Jenna McGrath
• Meghan McGraw
• Lauren McGreevy, LCSW
• Chloe Rose McGregor
• Tylor Megan McGrew

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.