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North Davis Anesthesiology LLC

Organization Active NPI Anesthesiology Physician · Layton, UT

NPI 1679525901 · NPPES record last updated May 22, 2019

Key facts

NPI
1679525901
Entity type
Organization (NPI type 2)
Primary specialty
Anesthesiology Physician 207L00000X
Legal business name
NORTH DAVIS ANESTHESIOLOGY LLC
Practice address
1600 W Antelope Dr
Layton, UT 84041-1120
Phone
(801) 807-1000
NPI assigned
May 16, 2006
Organization subpart
No

Authorized official

Name
Dr. Clay Richardson, DO NPI 1295950731
Title
Managing Employee/President
Phone
(801) 432-2600

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

Practitioners 15

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in UT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050111000311 UT Part B Supplier - Clinic/Group Practice 5395793905 Receives reassigned benefits from 14 practitioners
Practice locations: Layton, UT

National Provider Directory

Locations

1600 W Antelope Dr
Layton, UT 84041
Phone (801) 807-1000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207L00000X Yes
Pain Medicine (Anesthesiology) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207LP2900X

Addresses

Primary practice location

1600 W Antelope Dr
Layton, UT 84041-1120

Mailing address

PO Box 3810
Salt Lake City, UT 84110-3810
Phone (801) 432-2600

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 22, 2019.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1679525901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103810",
            "telephone_number": "801-432-2600",
            "fax_number": "770-701-6674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W ANTELOPE DR",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411120",
            "telephone_number": "801-807-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH DAVIS ANESTHESIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "CLAY",
        "authorized_official_title_or_position": "MANAGING EMPLOYEE/PRESIDENT",
        "authorized_official_telephone_number": "801-432-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

All providers in Layton, UT · Anesthesiology Physician in Utah

Sources for this page

Verify at the official NPI Registry.