NPIMap

Organization Active NPI

Pediatric Orthopedic Associates

  • Pediatric Radiology Physician
  • Salt Lake City, UT
National Provider Identifier
1659488799
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
Legal business name
PEDIATRIC ORTHOPEDIC ASSOCIATES
Practice address
100 Mario Capecchi Dr
Salt Lake City, UT 84112-8924
Phone
(801) 588-3900
NPI assigned
Aug 24, 2006
Last updated
Oct 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Authorized official

Name
Alan Kendrick Stotts, MDNPI 1902859473
Title
Department Chair
Phone
(801) 588-3900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X
Neuroradiology Physician 2085N0700X
Pediatric Radiology Physician 2085P0229X Primary
Diagnostic Radiology Physician 2085R0202X

Addresses

Primary practice location

100 Mario Capecchi Dr
Salt Lake City, UT 84112-8924

Mailing address

PO Box 58886
Salt Lake City, UT 84158-0886
Phone (801) 213-8300

Other identifiers 3

IdentifierTypeStateIssuer
22074538OtherCOCOLORADO MEDICAID
806656500OtherIDIDAHO MEDICAID
122394100OtherWYWYOMING MEDICIAD

National Provider Directory

National Provider Directory

Locations

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

Practitioners & affiliated clinicians

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1659488799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58886",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841580886",
            "telephone_number": "801-213-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841128924",
            "telephone_number": "801-588-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ORTHOPEDIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-10-16",
        "status": "A",
        "authorized_official_last_name": "STOTTS",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "KENDRICK",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "801-588-3900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO MEDICAID",
            "identifier": "22074538",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO MEDICAID",
            "identifier": "806656500",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WYOMING MEDICIAD",
            "identifier": "122394100",
            "state": "WY"
        }
    ],
    "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 Oct 16, 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.

Verify at the official NPI Registry.