Wasatch Geriatrics PC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

294016-2401 Issued in UT

Legal business name

WASATCH GERIATRICS PC

Practice address

1414 E 4500 S
#1
Salt Lake City, UT 84117-4228

Phone

(801) 272-0255

Fax

(801) 947-0840

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Charles Steven Fehlauer, MDNPI 1932285418

Title

Owner

Phone

(801) 824-2748

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Steven Fehlauer, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Sandy, UT
  • NPI 1932285418
  Medicare reassignment NPD Authorized official
• Perrine Johnson Anderson, APRN

  • Gerontology Nurse Practitioner
  • Sandy, UT
  • NPI 1447222849
  NPD (past)
• Frederick L Gottlieb, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Salt Lake City, UT
  • NPI 1174532931
  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776816000000",
    "number": "1619993276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2773 E ETIENNE WAY",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840931116",
            "telephone_number": "801-824-2748",
            "fax_number": "801-272-4983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 E 4500 S",
            "address_2": "#1",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174228",
            "telephone_number": "801-272-0255",
            "fax_number": "801-947-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASATCH GERIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A",
        "authorized_official_last_name": "FEHLAUER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-824-2748",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "UT",
            "license": "294016-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wasatch Nurse Practitioner Services

• Geriatric Medicine (Internal Medicine) Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Geriatric Medicine (Internal Medicine) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.