Active NPI
University of Utah Hospitals and Clinics
- Family Medicine Physician
- Stansbury Park, UT
National Provider Identifier
1629234752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- UNIVERSITY OF UTAH HOSPITALS AND CLINICS
- Practice address
- 220 Millpond
Ste. 100
Stansbury Park, UT 84074-9745 - Phone
- (435) 843-3000
- NPI assigned
- Jul 29, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Susan A Terry, MD
- Title
- Medical Director
- Phone
- (801) 587-6307
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | |||
| Registered Nurse | 163W00000X | |||
| Family Medicine Physician | 207Q00000X | Primary | ||
| Internal Medicine Physician | 207R00000X | |||
| Obstetrics & Gynecology Physician | 207V00000X | |||
| Pediatrics Physician | 208000000X | |||
| Physical Medicine & Rehabilitation Physician | 208100000X | |||
| Podiatrist | 213E00000X | |||
| Physical Therapist | 225100000X | |||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X | |||
| Advanced Practice Midwife | 367A00000X |
Addresses
Primary practice location
220 Millpond
Ste. 100
Stansbury Park, UT 84074-9745
Mailing address
PO Box 510708
Salt Lake City, UT 84151-0708
Phone (801) 587-6303
Other names 1
- UUHC Stansbury Clinic
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217289600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1217289600000",
"number": "1629234752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 510708",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841510708",
"telephone_number": "801-587-6303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 MILLPOND",
"address_2": "STE. 100",
"city": "STANSBURY PARK",
"state": "UT",
"postal_code": "840749745",
"telephone_number": "435-843-3000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNIVERSITY OF UTAH HOSPITALS AND CLINICS",
"organizational_subpart": "NO",
"enumeration_date": "2008-07-29",
"last_updated": "2008-07-29",
"status": "A",
"authorized_official_last_name": "TERRY",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "801-587-6307",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": null,
"license": null,
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Advanced Practice Midwife",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "UUHC Stansbury Clinic",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Stansbury Park, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.