NPIMap

Organization Active NPI

Molina Healthcare of Utah Inc

  • Family Nurse Practitioner
  • Midvale, UT
National Provider Identifier
1619486396
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MOLINA HEALTHCARE OF UTAH INC
Practice address
7050 S Union Park Ave Ste 200
Midvale, UT 84047-4171
Phone
(888) 562-5442
Fax
(562) 499-6191
NPI assigned
Sep 25, 2017
Last updated
Nov 8, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MOLINA HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Authorized official

Name
Gina Turley
Title
VP, Clinic Informatics
Phone
(888) 562-5442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

7050 S Union Park Ave Ste 200
Midvale, UT 84047-4171

Mailing address

200 Oceangate Ste 100
Long Beach, CA 90802-4317
Phone (888) 562-5442

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171204002662 UT Part B Supplier - Clinic/Group Practice 8224395041 Receives reassigned benefits from 74 practitioners
Practice locations: Midvale, UT

National Provider Directory

National Provider Directory
Part of
Molina Healthcare

Locations

7050 S Union Park Ave
Ste 200
Midvale, UT 84047
Phone (562) 549-3966

Interoperability endpoints

  • FHIR API: https://epicproxy.et1057.epichosted.com/FHIRProxy/api/FHIR/R4/

Practitioners & affiliated clinicians

Practitioners 76

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 76

NPI Registry JSON

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

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731024000000",
    "number": "1619486396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "888-562-5442",
            "fax_number": "562-499-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 S UNION PARK AVE STE 200",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840474171",
            "telephone_number": "888-562-5442",
            "fax_number": "562-499-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLINA HEALTHCARE OF UTAH INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOLINA HEALTHCARE",
        "enumeration_date": "2017-09-25",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A",
        "authorized_official_last_name": "TURLEY",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "VP, CLINIC INFORMATICS",
        "authorized_official_telephone_number": "888-562-5442"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.