Active NPI
Thomas M Mahoney, AUDIOLOGIST
- Audiologist
- Salt Lake City, UT
National Provider Identifier
1659400604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 100926-9937
- Practice address
- 44 N Medical Dr
Salt Lake City, UT 84113-1105 - Phone
- (801) 584-8215
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 100926-9937 | UT | Primary |
Addresses
Primary practice location
44 N Medical Dr
Salt Lake City, UT 84113-1105
Mailing address
240 Parkview Dr
Park City, UT 84098-5144
Phone (435) 649-5394
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 999000021033 | Medicaid | UT |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100926-9937 | UT | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1659400604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 PARKVIEW DR",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840985144",
"telephone_number": "435-649-5394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 N MEDICAL DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131105",
"telephone_number": "801-584-8215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHONEY",
"first_name": "THOMAS",
"middle_name": "M",
"credential": "AUDIOLOGIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "UT",
"license": "100926-9937",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "999000021033",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.