NPIMap

Individual provider Active NPI

Rex A Outtrim, MD

  • Cardiovascular Disease Physician
  • Riverton, UT
National Provider Identifier
1558355313
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
5006181205 Issued in UT
Practice address
3723 W 12600 S
Riverton, UT 84065-7295
Phone
(801) 285-4590
NPI assigned
Sep 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 5006181205 UT Primary

Addresses

Primary practice location

3723 W 12600 S
Riverton, UT 84065-7295

Mailing address

5121 S Cottonwood St
Suite 520
Salt Lake City, UT 84107-5701
Phone (801) 507-3500

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
I20051015000082 UT Practitioner - Cardiovascular Disease (Cardiology) 4385632918 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

3741 W 12600
Riverton, UT 84065-7215
Phone 80144232237215

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5006181205UTMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jan 1, 2011 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Ihc Health Services Inc CurrentSince Apr 10, 2011 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 1, 2011 Accepting new patients
Ihc Health Services Inc Family Medicine Past Accepting new patients
Northern Utah Healthcare Corporation Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients
Ihc Health Services Inc Cardiovascular Disease Past Accepting new patients

Locations

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

3741 W 12600 S
Ste 120
Riverton, UT 84065

3741 W 12600 S
Ste 160A
Riverton, UT 84065

3723 W 12600 S
Riverton, UT 84065
Phone (801) 285-2482

3741 W 12600 S
Riverton, UT 84065
Phone (801) 285-2400

5169 S Cottonwood St
Ste 520
Salt Lake City, UT 84107
Phone (801) 507-3555

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

8th Ave C St
Salt Lake City, UT 84143
Phone (801) 269-2500

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

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

9450 S 1300 E
Ste 210
Sandy, UT 84094
Phone (801) 501-4305

9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417

9450 S 1300 E
Sandy, UT 84094
Phone (801) 501-2133

1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111

Organizations & group practices 9

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

Hospital & facility affiliations 7

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": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1558355313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST",
            "address_2": "SUITE 520",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "801-507-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3723 W 12600 S",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657295",
            "telephone_number": "801-285-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTTRIM",
        "first_name": "REX",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "UT",
            "license": "5006181205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

Verify at the official NPI Registry.