Organization Active NPI

RT Health, LLC

  • Dermatology Physician
  • Salt Lake City, UT
National Provider Identifier
1548003577
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
RT HEALTH, LLC
Practice address
4141 S Highland Dr Ste 204
Salt Lake City, UT 84124-2642
Phone
(215) 806-0030
NPI assigned
Jun 17, 2024
Last updated
Jun 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Authorized official

Name
Dr. Tamara Stein Jenen, MD
Title
Medical Director
Phone
(215) 806-0030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

4141 S Highland Dr Ste 204
Salt Lake City, UT 84124-2642

Mailing address

4141 S Highland Dr Ste 204
Salt Lake City, UT 84124-2642

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250218002133 UT Part B Supplier - Clinic/Group Practice 3971023151 Receives reassigned benefits from 1 practitioner
Practice locations: Holladay, UT

National Provider Directory

National Provider Directory

Locations

4141 S Highland Dr
Ste 204
Salt Lake City, UT 84124
Phone (215) 806-0030

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1548003577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 S HIGHLAND DR STE 204",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 S HIGHLAND DR STE 204",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242642",
            "telephone_number": "215-806-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RT HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "JENEN",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "STEIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "215-806-0030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 17, 2024; 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.