NPIMap

Organization Active NPI

Shelly Savage M D LLC

  • Family Medicine Physician
  • Provo, UT
National Provider Identifier
1669652343
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4775407-1205 Issued in UT
Legal business name
SHELLY SAVAGE M D LLC
Practice address
1900 N State St
Provo, UT 84604-1341
Phone
(801) 373-2001
Fax
(801) 373-4748
NPI assigned
Nov 9, 2007
Last updated
Feb 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Authorized official

Name
Shelly Savage, MDNPI 1194876078
Title
Owner
Phone
(801) 373-2001

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4775407-1205 UT Primary

Addresses

Primary practice location

1900 N State St
Provo, UT 84604-1341

Mailing address

1900 N State St
Provo, UT 84604-1341
Phone (801) 373-2001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727000178 UT Part B Supplier - Clinic/Group Practice 7315917697 Receives reassigned benefits from 11 practitioners
Practice locations: Cedar Hills, UT; Provo, UT

National Provider Directory

National Provider Directory

Locations

4587 W Cedar Hills Dr
Ste 210
Cedar Hills, UT 84062
Phone (801) 373-2001

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1669652343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 N STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041341",
            "telephone_number": "801-373-2001",
            "fax_number": "801-373-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041341",
            "telephone_number": "801-373-2001",
            "fax_number": "801-373-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELLY SAVAGE M D LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "SAVAGE",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-373-2001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "4775407-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.