Active NPI
RT Health, LLC
- Dermatology Physician
- Salt Lake City, UT
National Provider Identifier
1548003577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- 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, 2024
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider DirectoryLocations
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.