Salt Lake Endoscopy Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

2006-ASF-332 Issued in UT

Legal business name

SALT LAKE ENDOSCOPY CENTER

Practice address

24 S 1100 E Ste 103
Salt Lake City, UT 84102-1592

Phone

(801) 355-2987

Fax

(801) 531-9704

NPI assigned

Jul 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Stewart L Ellington, DR

Title

President

Phone

(801) 364-5767

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609896216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 SOUTH 1100 EAST #103",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84102",
            "telephone_number": "801-355-2987",
            "fax_number": "801-531-9704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 S 1100 E STE 103",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021592",
            "telephone_number": "801-355-2987",
            "fax_number": "801-531-9704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT LAKE ENDOSCOPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLINGTON",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-364-5767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DR"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "UT",
            "license": "2006-ASF-332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Ambulatory Surgical Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.