Pediatric Genetics Department of University of Utah

Primary specialty

Genetic Counselor (M.S.)Taxonomy code 170300000X

License

9858866-3602 Issued in UT

Legal business name

PEDIATRIC GENETICS DEPARTMENT OF UNIVERSITY OF UTAH

Practice address

Department of Pediatrics
50 North Mario Capecchi Drive
Salt Lake City, UT 84132-0001

Phone

(801) 581-8943

Fax

(801) 585-7252

NPI assigned

Aug 19, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Edward B. Clark

Title

Department Chair

Phone

(801) 587-7415

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471564800000",
    "number": "1669927695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PEDIATRICS",
            "address_2": "50 NORTH MARIO CAPECCHI DRIVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-8943",
            "fax_number": "801-585-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PEDIATRICS",
            "address_2": "50 NORTH MARIO CAPECCHI DRIVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-8943",
            "fax_number": "801-585-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC GENETICS DEPARTMENT OF UNIVERSITY OF UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-19",
        "last_updated": "2016-08-19",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "801-587-7415",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Genetic Counselor, MS",
            "state": "UT",
            "license": "9858866-3602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Emergency Medicine Department of University of Utah
• Pediatric Emergency Sedation Service
• Pediatric Endocrinology Department of University of Utah
• Pediatric Gastroenterology Department of University of Utah
• Pediatric Genetics Department of University of Utah
• Pediatric Hematology Oncology-Department of University of Utah
• Pediatric Immunology Department of University of Utah
• Pediatric Infectious Disease Department of University of Utah
• Pediatric Inpatient Services Department of University of Utah
• Pediatric Neonatology Department of University of Utah

• Genetic Counselor (M.S.) in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Genetic Counselor (M.S.) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; 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.