NPIMap

Organization Active NPI

University of Utah Pediatric Neurology

  • Multi-Specialty Clinic/Center
  • Riverton, UT
National Provider Identifier
1508178476
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
48547254405 Issued in UT
Legal business name
UNIVERSITY OF UTAH PEDIATRIC NEUROLOGY
Practice address
3741 W 12600 S
Riverton, UT 84065-7215
Phone
(801) 285-4000
NPI assigned
Jul 8, 2010
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Edward B Clark, MD
Title
Chairman
Phone
(801) 587-7400

National Provider Directory

National Provider Directory
Tax ID family
Bruce D Etringer PHD54 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 48547254405 UT Primary

Addresses

NPPES NPI Registry

Primary practice location

3741 W 12600 S
Riverton, UT 84065-7215

Mailing address

100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (801) 662-5696

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2010.

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278547200000",
    "number": "1508178476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-5696",
            "fax_number": "801-662-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3741 W 12600 S",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657215",
            "telephone_number": "801-285-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH PEDIATRIC NEUROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-08",
        "last_updated": "2010-07-08",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "801-587-7400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "UT",
            "license": "48547254405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; 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.