Identity Hormones Ut LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

IDENTITY HORMONES UT LLC

Practice address

1327 E 2100 S Ste 101
Salt Lake City, UT 84105-3763

Phone

(602) 354-3925

NPI assigned

Jun 29, 2022

Organization subpart

No

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

Authorized official

Name

Teah Smith

Title

Credentialing Manager

Phone

(901) 205-3999

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Joshua Jorgensen, MSN, FNP-C

  • Family Nurse Practitioner
  • Salt Lake City, UT
  • NPI 1013657014
  NPD

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699833600000",
    "number": "1669104402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 E 2100 S STE 101",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 E 2100 S STE 101",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053763",
            "telephone_number": "602-354-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDENTITY HORMONES UT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-29",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TEAH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "901-205-3999"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aldena Ibarguen
• Anna R. Ibele, M.D.
• Chadi Ibrahim, M.D.
• Marwo Ibrahim
• Idbydna Inc.
• April Idle
• Ignatz Nascher Medical Services
• Ignition LLC
• Elizabeth Ann Igo
• Keiko Ihara, MD

• Family Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.