NPIMap

Individual provider Active NPI

Jason Spaulding, MD

  • Internal Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1508987421
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
6019949-1205 Issued in UT
Practice address
LDS Hospital Hospitalists
8TH Avenue and C Street
Salt Lake City, UT 84143-0001
Phone
(801) 408-5482
Fax
(801) 408-5481
NPI assigned
Apr 2, 2007
Last updated
Jun 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 6019949-1205 UT Primary

Addresses

Primary practice location

LDS Hospital Hospitalists
8TH Avenue and C Street
Salt Lake City, UT 84143-0001

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 408-5482

Other identifiers 1

IdentifierTypeStateIssuer
942854057043MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070730000424 UT Practitioner - Internal Medicine 4284735663 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

11520 S Redwood Rd
South Jordan, UT 84095-7805
Phone (385) 887-7300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6019949-1205UTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jul 1, 2007 Accepting new patients
Silverton Group LLC Hospitalist CurrentSince Oct 8, 2017 Accepting new patients
Ihc Health Services Inc Internal Medicine CurrentSince Jul 1, 2007 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

8th Ave And C St
Salt Lake City, UT 84143
Phone (801) 350-4110

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

11520 S Redwood Rd
South Jordan, UT 84095
Phone (385) 887-6000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1508987421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-408-5482",
            "fax_number": "801-408-5481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LDS HOSPITAL HOSPITALISTS",
            "address_2": "8TH AVENUE AND C STREET",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841430001",
            "telephone_number": "801-408-5482",
            "fax_number": "801-408-5481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAULDING",
        "first_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "6019949-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "942854057043",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.