NPIMap

Organization Active NPI

Utah Podiatry Group LLC

  • Foot & Ankle Surgery Podiatrist
  • Bountiful, UT
National Provider Identifier
1598205494
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
UTAH PODIATRY GROUP LLC
Practice address
520 Medical Dr Ste 230
Bountiful, UT 84010-8932
Phone
(801) 292-5070
NPI assigned
Feb 27, 2017
Last updated
Oct 27, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
UTAH PODIATRY GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Authorized official

Name
Scott A ClarkNPI 1700865748
Title
DPM
Phone
(801) 505-0821

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Podiatrist 213E00000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

520 Medical Dr Ste 230
Bountiful, UT 84010-8932

Mailing address

PO Box 849795
Los Angeles, CA 90084-9795
Phone (801) 451-6060

Other identifiers 2

IdentifierTypeStateIssuer
6152070010OtherUTDME PTAN
000063660OtherUTMEDICARE PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181030000694 UT DME Supplier - Physician - Podiatry 2163592379 Practice locations: Bountiful, UT

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Utah Podiatry Group PC13 organizations share this tax ID, including this one
Part of
Utah Podiatry Group PC

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761523200000",
    "number": "1598205494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 849795",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900849795",
            "telephone_number": "801-451-6060",
            "fax_number": "801-797-9154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MEDICAL DR STE 230",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108932",
            "telephone_number": "801-292-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH PODIATRY GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UTAH PODIATRY GROUP LLC",
        "enumeration_date": "2017-02-27",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "801-505-0821"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PTAN",
            "identifier": "6152070010",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "000063660",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.