Organization Active NPI

M D Urgent Medical Care LLC

  • Urgent Care Clinic/Center
  • Sandy, UT
National Provider Identifier
1558078113
Registry record updated Jul 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
M D URGENT MEDICAL CARE LLC
Practice address
1025 E 11400 S Ste 103
Sandy, UT 84094-6947
Phone
(912) 308-6496
NPI assigned
Nov 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2023

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

Authorized official

Name
Dr. David Nguyen, MDNPI 1245624220
Title
Medical Director
Phone
(912) 308-6496

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
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1025 E 11400 S Ste 103
Sandy, UT 84094-6947

Mailing address

1025 E 11400 S Ste 103
Sandy, UT 84094-6947
Phone (912) 308-6496

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221221003000 UT Part B Supplier - Clinic/Group Practice 7719357474 Receives reassigned benefits from 1 practitioner
Practice locations: Sandy, UT

National Provider Directory

National Provider Directory

Locations

1025 E 11400 S
Ste 103
Sandy, UT 84094
Phone (385) 452-1055

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688774400000",
    "number": "1558078113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 E 11400 S STE 103",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840946947",
            "telephone_number": "912-308-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 E 11400 S STE 103",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840946947",
            "telephone_number": "912-308-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M D URGENT MEDICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-03",
        "last_updated": "2023-07-08",
        "certification_date": "2023-07-08",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "912-308-6496",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2023; 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.