NPIMap

Organization Active NPI

University of Utah Adult Services

  • Clinical Cardiac Electrophysiology Physician
  • Elko, NV
National Provider Identifier
1629455282
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
Legal business name
UNIVERSITY OF UTAH ADULT SERVICES
Practice address
976 Mountian City Hwy
A Plus Total Care
Elko, NV 89801-2728
Phone
(775) 738-5151
NPI assigned
May 4, 2015
Organization subpart
Yes
Parent organization
UNIVERSITY OF UTAH ADULT SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Authorized official

Name
Edward Clark, MD
Title
Division Chief
Phone
(801) 587-6336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0001X Primary

Addresses

Primary practice location

976 Mountian City Hwy
A Plus Total Care
Elko, NV 89801-2728

Mailing address

PO Box 841450
Los Angeles, CA 90084-1450
Phone (801) 213-3900

Other names 1

  • Elko, EP Cardiology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150701001557 NV Part B Supplier - Clinic/Group Practice 0941525273 Receives reassigned benefits from 29 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elko, NV; Mesquite, NV

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
University of Utah Adult Services

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589846400000",
    "number": "1629455282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841450",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900841450",
            "telephone_number": "801-213-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "976 MOUNTIAN CITY HWY",
            "address_2": "A PLUS TOTAL CARE",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012728",
            "telephone_number": "775-738-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "enumeration_date": "2015-05-04",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "DIVISION CHIEF",
        "authorized_official_telephone_number": "801-587-6336",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elko, EP Cardiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elko, EP Cardiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elko, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.