NPIMap

Organization Active NPI

South Valley Ear Nose and Throat Associates, PLLC

  • Otolaryngology Physician
  • West Jordan, UT
National Provider Identifier
1508926551
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
163937-1205 Issued in UT
Legal business name
SOUTH VALLEY EAR NOSE AND THROAT ASSOCIATES, PLLC
Practice address
3584 W. 9000 S.
Suite 311
West Jordan, UT 84088-4775
Phone
(801) 566-8304
Fax
(801) 566-8330
NPI assigned
Dec 11, 2006
Last updated
Jun 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Authorized official

Name
Garner B. Meads, M.D.NPI 1760498026
Title
Managing Partner
Phone
(801) 566-8304

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 163937-1205 UT Primary

Addresses

Primary practice location

3584 W. 9000 S.
Suite 311
West Jordan, UT 84088-4775

Mailing address

3584 W. 9000 S.
Suite 311
West Jordan, UT 84088-4775
Phone (801) 566-8304

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040625000769 UT Part B Supplier - Clinic/Group Practice 9335125855 Receives reassigned benefits from 12 practitioners
Practice locations: West Jordan, UT

National Provider Directory

National Provider Directory

Locations

1225 E Fort Union Blvd
Ste 120
Midvale, UT 84047
Phone (801) 563-1116

4651 W 13400 S
Ste 120
Riverton, UT 84096

5169 S Cottonwood St
Ste 310
Salt Lake City, UT 84107
Phone (801) 507-3444

24 W Sergeant Court Dr
Ste 102
Saratoga Springs, UT 84045
Phone (801) 407-3048

3584 W 9000 S
Ste 311
West Jordan, UT 84088
Phone (801) 566-8304

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1508926551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3584 W. 9000 S.",
            "address_2": "SUITE 311",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840884775",
            "telephone_number": "801-566-8304",
            "fax_number": "801-566-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3584 W. 9000 S.",
            "address_2": "SUITE 311",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840884775",
            "telephone_number": "801-566-8304",
            "fax_number": "801-566-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH VALLEY EAR NOSE AND THROAT ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "MEADS",
        "authorized_official_first_name": "GARNER",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "801-566-8304",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "163937-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.