Utah Neurorehabilitation, Inc

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

1754861205 Issued in UT

Legal business name

UTAH NEUROREHABILITATION, INC

Practice address

4398 Adonis Dr
Salt Lake City, UT 84124-3433

Phone

(801) 750-6933

NPI assigned

Apr 1, 2012

Organization subpart

No

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

Authorized official

Name

Judigh Gooch, MD

Title

President

Phone

(801) 750-6933

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Judith L Gooch, MD

  • Physical Medicine & Rehabilitation Physician
  • SLC, UT
  • NPI 1437268588
  Medicare reassignment NPD

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

{
    "created_epoch": "1333238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333238400000",
    "number": "1548536725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4398 ADONIS DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841243433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4398 ADONIS DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841243433",
            "telephone_number": "801-750-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH NEUROREHABILITATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-01",
        "last_updated": "2012-04-01",
        "status": "A",
        "authorized_official_last_name": "GOOCH",
        "authorized_official_first_name": "JUDIGH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-750-6933",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "UT",
            "license": "1754861205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Utah Infertility Resource Center
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• Utah Neuropsychiatric Institute
• Utah Oculoplastic Consultants, P.C.
• Utah Oral Surgery & Dental Implant Center
• Utah Orthodontic Care,P.C.
• Utah Orthopedic, Spine & Injury Center
• Utah Patient Advocates, Inc

• Physical Medicine & Rehabilitation Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physical Medicine & Rehabilitation Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2012; 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.