Individual provider Active NPI

Claudia J Fruin, MD

  • Pediatrics Physician
  • Salt Lake City, UT
National Provider Identifier
1619959319
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
181369-1205 Issued in UT
Practice address
44 N. Mario Capecchi Dr
Salt Lake City, UT 84113-1105
Phone
(801) 584-8271
Fax
(801) 584-8488
NPI assigned
Nov 17, 2005
Last updated
Feb 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 181369-1205 UT Primary

Addresses

Primary practice location

44 N. Mario Capecchi Dr
Salt Lake City, UT 84113-1105

Mailing address

44 N. Medical Dr.
PO Box 144610
Salt Lake City, UT 84113
Phone (801) 584-8271

Other names 1

  • Claudia M Jerit Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
181369-1205UTMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1619959319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 N. MEDICAL DR.",
            "address_2": "PO BOX 144610",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84113",
            "telephone_number": "801-584-8271",
            "fax_number": "801-584-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 N. MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131105",
            "telephone_number": "801-584-8271",
            "fax_number": "801-584-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUIN",
        "first_name": "CLAUDIA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "181369-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLAUDIA",
            "last_name": "JERIT",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.