Active NPI
Crestwood Medical Group Inc
- Family Medicine Physician
- Kaysville, UT
National Provider Identifier
1578732137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 161981-1205
- Legal business name
- CRESTWOOD MEDICAL GROUP INC
- Practice address
- 47 Crestwood Rd
Ste #2
Kaysville, UT 84037-1445 - Phone
- (801) 546-1273
- Fax
- (801) 546-1631
- NPI assigned
- Feb 27, 2008
- Organization subpart
- Yes
- Parent organization
- CRESTWOOD MEDICAL GROUP INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. John B Taylor, MD
- Title
- President Owner
- Phone
- (801) 546-1273
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 161981-1205 | UT | Primary |
Addresses
Primary practice location
47 Crestwood Rd
Ste #2
Kaysville, UT 84037-1445
Mailing address
47 Crestwood Rd
Ste #2 Crestwood Medical Group
Kaysville, UT 84037-1445
Phone (801) 546-1273
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 248783020008 | Medicaid | UT |
National Provider Directory
National Provider Directory- Part of
- Crestwood Medical Inc
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Stansbury PK, UT
- NPI 1790874238
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204070400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1204070400000",
"number": "1578732137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 CRESTWOOD RD",
"address_2": "STE #2 CRESTWOOD MEDICAL GROUP",
"city": "KAYSVILLE",
"state": "UT",
"postal_code": "840371445",
"telephone_number": "801-546-1273",
"fax_number": "801-546-1631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 CRESTWOOD RD",
"address_2": "STE #2",
"city": "KAYSVILLE",
"state": "UT",
"postal_code": "840371445",
"telephone_number": "801-546-1273",
"fax_number": "801-546-1631"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CRESTWOOD MEDICAL GROUP INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CRESTWOOD MEDICAL GROUP INC",
"enumeration_date": "2008-02-27",
"last_updated": "2008-02-27",
"status": "A",
"authorized_official_last_name": "TAYLOR",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "PRESIDENT OWNER",
"authorized_official_telephone_number": "801-546-1273",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "UT",
"license": "161981-1205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "248783020008",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kaysville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.