NPIMap

Organization Active NPI

Harold N Gooch MD LLC

  • Family Medicine Physician
  • Draper, UT
National Provider Identifier
1508073743
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
181191-1205 Issued in UT
Legal business name
HAROLD N GOOCH MD LLC
Practice address
12176 S 1000 E
Draper, UT 84020-9716
Phone
(801) 572-3750
Fax
(801) 572-1097
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Authorized official

Name
Ben Gunn
Title
Office Manager
Phone
(801) 572-3750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 181191-1205 UT Primary

Addresses

Primary practice location

12176 S 1000 E
Draper, UT 84020-9716

Mailing address

PO Box 150610
Ogden, UT 84415-0610
Phone (801) 476-9200

Other identifiers 1

IdentifierTypeStateIssuer
36972175003001OtherUTBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1508073743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150610",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844150610",
            "telephone_number": "801-476-9200",
            "fax_number": "801-476-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12176 S 1000 E",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209716",
            "telephone_number": "801-572-3750",
            "fax_number": "801-572-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAROLD N GOOCH MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "GUNN",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-572-3750"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "181191-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "36972175003001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.