NPIMap

Organization Active NPI

University of Utah Adult Services

Doing business as U of U Medical Genetics

  • Clinical Genetics (M.D.) Physician
  • Salt Lake City, UT
National Provider Identifier
1508222167
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
Legal business name
UNIVERSITY OF UTAH ADULT SERVICES
Doing business as
U of U Medical Genetics
Practice address
50 N Medical Dr
Clinic 1
Salt Lake City, UT 84132-0100
Phone
(801) 581-2628
NPI assigned
Jan 12, 2016
Last updated
May 20, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF UTAH ADULT SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Authorized official

Name
Edward Clark
Title
Dept Chair
Phone
(801) 587-6336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X Primary

Addresses

Primary practice location

50 N Medical Dr
Clinic 1
Salt Lake City, UT 84132-0100

Mailing address

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

Other names 1

  • U of U Medical Genetics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150209001683 UT Part B Supplier - Clinic/Group Practice 0941525273 Receives reassigned benefits from 3,021 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Sandy, UT; Salt Lake City, UT; Farmington, UT

National Provider Directory

National Provider Directory
Tax ID family
Univ of Utah Adult Serv34 organizations share this tax ID, including this one
Part of
Univ of Utah Adult Serv

Other organizations with this tax ID 33

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

View all 33

Locations

50 N Medical Dr
#1
Salt Lake City, UT 84132
Phone (801) 213-2033

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589932800000",
    "number": "1508222167",
    "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": "50 N MEDICAL DR",
            "address_2": "CLINIC 1",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320100",
            "telephone_number": "801-581-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "enumeration_date": "2016-01-12",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "DEPT CHAIR",
        "authorized_official_telephone_number": "801-587-6336"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U of U Medical Genetics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "U of U Medical Genetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.