NPIMap

Organization Active NPI

Western Gynecological and Obstetrical Clinic, Inc.

  • Obstetrics & Gynecology Physician
  • Riverton, UT
National Provider Identifier
1619159795
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
1499-07 Issued in UT
Legal business name
WESTERN GYNECOLOGICAL AND OBSTETRICAL CLINIC, INC.
Practice address
12842 S 3600 W Ste 200
Riverton, UT 84065-6853
Phone
(801) 285-4800
Fax
(801) 285-4801
NPI assigned
Nov 30, 2007
Last updated
Feb 24, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Authorized official

Name
Mindy Thorne
Title
Practice Administrator
Phone
(801) 285-4800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 1499-07 UT Primary

Addresses

Primary practice location

12842 S 3600 W Ste 200
Riverton, UT 84065-6853

Mailing address

12842 S 3600 W Ste 200
Riverton, UT 84065-6853
Phone (801) 285-4800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031222000955 UT Part B Supplier - Clinic/Group Practice 8325946700 Receives reassigned benefits from 9 practitioners
Practice locations: Riverton, UT

National Provider Directory

National Provider Directory

Locations

12842 S 3600 W
Ste 200
Riverton, UT 84065
Phone (801) 285-4800

3723 W 12600 S
Ste 350
Riverton, UT 84065
Phone (801) 285-4730

Practitioners & affiliated clinicians

Practitioners 35

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 35

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614124800000",
    "number": "1619159795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12842 S 3600 W STE 200",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840656853",
            "telephone_number": "801-285-4800",
            "fax_number": "801-285-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12842 S 3600 W STE 200",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840656853",
            "telephone_number": "801-285-4800",
            "fax_number": "801-285-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN GYNECOLOGICAL AND OBSTETRICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A",
        "authorized_official_last_name": "THORNE",
        "authorized_official_first_name": "MINDY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "801-285-4800"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "1499-07",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.