University of Utah Otolaryngology Pediatrics

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

UNIVERSITY OF UTAH OTOLARYNGOLOGY PEDIATRICS

Practice address

100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103

Phone

(801) 588-2000

NPI assigned

Aug 5, 2006

Last updated

Apr 14, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Janell I Madonna

Title

Director of Contracting and Pe

Phone

(801) 587-6464

Specialties & licenses 4

Addresses

Other identifiers 4

Practitioners 5

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.

• Alicia K. Crofts, CCC-A

  • Audiologist
  • Salt Lake City, UT
  • NPI 1700976396
  NPD (past)
• Lisa Dahlstrom, CCC-A

  • Audiologist
  • Salt Lake City, UT
  • NPI 1326138918
  NPD (past)
• Jason P Hunt, M.D.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Salt Lake City, UT
  • NPI 1053334805
  NPD (past)
• Leland P. Johnson, MD

  • Otolaryngology Physician
  • Salt Lake City, UT
  • NPI 1609966209
  NPD (past)
• Steven Michael Kelly, M.D.

  • Pediatric Otolaryngology Physician
  • Bountiful, UT
  • NPI 1841348240
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239667200000",
    "number": "1508875857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413035",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841410001",
            "telephone_number": "801-213-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-588-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH OTOLARYNGOLOGY PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2009-04-14",
        "status": "A",
        "authorized_official_last_name": "MADONNA",
        "authorized_official_first_name": "JANELL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTING AND PE",
        "authorized_official_telephone_number": "801-587-6464"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805957800",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45200289",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ3240",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57507325",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• University of Utah Neuro-Ophthalmology
• University of Utah Neuromuscular
• University of Utah OB Care Now
• University of Utah OB Diagnostic Center
• University of Utah Orthopedic Consultants
• University of Utah Pain Management Physicians Group
• University of Utah Pediatric Acuity Care (Pediatric Emergency Medicine)
• University of Utah Pediatric Acuity Care (Neurostimulation Pediatric Services)
• University of Utah Pediatric Acuity Care
• University of Utah Pediatric Acuity Care (Pediatric Neonatology)

• Otolaryngology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Otolaryngology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2009; 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.