NPIMap

Organization Active NPI

Interventional Spine & Pain Management

  • Pain Medicine (Anesthesiology) Physician
  • Murray, UT
National Provider Identifier
1609204338
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
INTERVENTIONAL SPINE & PAIN MANAGEMENT
Practice address
5801 S Fashion Blvd Ste 180
Murray, UT 84107-8135
Phone
(801) 262-7246
NPI assigned
Oct 15, 2013
Last updated
Nov 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Authorized official

Name
Dr. Vikas Garg, M.D.NPI 1104852599
Title
Owner
Phone
(801) 262-7246

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
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

5801 S Fashion Blvd Ste 180
Murray, UT 84107-8135

Mailing address

274 N Main St
Logan, UT 84321-3915
Phone (435) 753-1600

Other practice location 1

13953 S Bangerter Pkwy
Draper, UT 84020-5429
Phone (801) 262-7246

Other practice location 2

900 Round Valley Dr Ste 120
Park City, UT 84060-7552
Phone (801) 262-7246

Other practice location 3

1276 Wall Ave Ste 2
Ogden, UT 84404-5673
Phone (801) 262-7246

Other practice location 4

2380 N 400 E Ste A
North Logan, UT 84341-1756
Phone (435) 713-9681

Other practice location 5

346 E State Rd
Pleasant Grove, UT 84062-3617
Phone (801) 262-7246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140219000458 UT Part B Supplier - Clinic/Group Practice 6204065162 Receives reassigned benefits from 21 practitioners
Practice locations: Draper, UT; Tooele, UT; South Jordan, UT; Salt Lake City, UT; Provo, UT; Pleasant Grove, UT; Payson, UT; Orem, UT…

National Provider Directory

National Provider Directory

Locations

15 S 1000 E
Ste 100
Payson, UT 84651
Phone (385) 345-3560

346 E State Rd
Pleasant Grove, UT 84062

5801 S Fashion Blvd
Ste 180
Salt Lake City, UT 84107
Phone (801) 706-2100

2321 N 400 E
Ste 300
Tooele, UT 84074
Phone (435) 833-9180

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HDBECA

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1381795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574294400000",
    "number": "1609204338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 N MAIN ST",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843213915",
            "telephone_number": "435-753-1600",
            "fax_number": "435-753-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 S FASHION BLVD STE 180",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841078135",
            "telephone_number": "801-262-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13953 S Bangerter Pkwy",
            "address_purpose": "LOCATION",
            "city": "Draper",
            "state": "UT",
            "postal_code": "840205429",
            "country_code": "US",
            "telephone_number": "801-262-7246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Round Valley Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Park City",
            "state": "UT",
            "postal_code": "840607552",
            "country_code": "US",
            "telephone_number": "801-262-7246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1276 Wall Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844045673",
            "country_code": "US",
            "telephone_number": "801-262-7246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2380 N 400 E Ste A",
            "address_purpose": "LOCATION",
            "city": "North Logan",
            "state": "UT",
            "postal_code": "843411756",
            "country_code": "US",
            "telephone_number": "435-713-9681",
            "fax_number": "435-753-1201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "346 E State Rd",
            "address_purpose": "LOCATION",
            "city": "Pleasant Grove",
            "state": "UT",
            "postal_code": "840623617",
            "country_code": "US",
            "telephone_number": "801-262-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTERVENTIONAL SPINE & PAIN MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-15",
        "last_updated": "2019-11-21",
        "status": "A",
        "authorized_official_last_name": "GARG",
        "authorized_official_first_name": "VIKAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-262-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; 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.