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University of Utah Adult Services

Organization Active NPI Internal Medicine Physician · Elko, NV

NPI 1497280937 · NPPES record last updated May 19, 2020

Key facts

NPI
1497280937
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
UNIVERSITY OF UTAH ADULT SERVICES
Practice address
976 Mountian City Hwy
A Plus Total Care
Elko, NV 89801-2728
Phone
(775) 738-5151
NPI assigned
Apr 21, 2017
Organization subpart
Yes
Parent organization (as reported)
UNIVERSITY OF UTAH ADULT SERVICES

Authorized official

Name
Edward Clark, MD
Title
Department Chair
Phone
(801) 587-6336

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NV

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20150701001557 NV Part B Supplier - Clinic/Group Practice 0941525273 Receives reassigned benefits from 29 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elko, NV; Mesquite, NV

National Provider Directory

Tax ID family
University of Utah Adult Services (34 organizations share this tax ID)
Part of
University of Utah Adult Services

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X Yes

Addresses

Primary practice location

976 Mountian City Hwy
A Plus Total Care
Elko, NV 89801-2728

Mailing address

PO Box 841450
Los Angeles, CA 90084-1450
Phone (801) 213-3900

Other names

  • Elko, General Cardiology Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 19, 2020.

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589846400000",
    "number": "1497280937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841450",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900841450",
            "telephone_number": "801-213-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "976 MOUNTIAN CITY HWY",
            "address_2": "A PLUS TOTAL CARE",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012728",
            "telephone_number": "775-738-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "enumeration_date": "2017-04-21",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "801-587-6336",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elko, General Cardiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elko, General Cardiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elko, NV

All providers in Elko, NV · Internal Medicine Physician in Nevada

Sources for this page

Verify at the official NPI Registry.