Organization Active NPI

Mountain Vista Medicine

  • Pediatric Endocrinology Physician
  • South Jordan, UT
National Provider Identifier
1609123512
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
292580-1205 Issued in UT
Legal business name
MOUNTAIN VISTA MEDICINE
Practice address
1258 W South Jordan Pkwy
103
South Jordan, UT 84095
Phone
(801) 838-9090
Fax
(801) 838-9092
NPI assigned
Aug 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Authorized official

Name
Mike T Swinyard, MD
Title
Owner
Phone
(801) 838-9090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0205X 292580-1205 UT Primary

Addresses

Primary practice location

1258 W South Jordan Pkwy
103
South Jordan, UT 84095

Mailing address

1258 W South Jordan Pkwy
103
South Jordan, UT 84095-4711
Phone (801) 838-9090

Other identifiers 1

IdentifierTypeStateIssuer
1245222819OtherINDIVDUAL NPI

National Provider Directory

National Provider Directory

Locations

1258 W South Jordan Pkwy
Ste 103
South Jordan, UT 84095
Phone (801) 838-9090

Practitioners & affiliated clinicians

Practitioners 2

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": "1344470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530489600000",
    "number": "1609123512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 W SOUTH JORDAN PKWY",
            "address_2": "103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954711",
            "telephone_number": "801-838-9090",
            "fax_number": "801-838-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 W SOUTH JORDAN PKWY",
            "address_2": "103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84095",
            "telephone_number": "801-838-9090",
            "fax_number": "801-838-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VISTA MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-09",
        "last_updated": "2018-07-02",
        "status": "A",
        "authorized_official_last_name": "SWINYARD",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-838-9090",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "UT",
            "license": "292580-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVDUAL NPI",
            "identifier": "1245222819",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.