NPIMap

Organization Active NPI

Granite Peaks Gi, LLC

  • Gastroenterology Physician
  • Sandy, UT
National Provider Identifier
1689872897
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2901281205 Issued in UT
Legal business name
GRANITE PEAKS GI, LLC
Practice address
1393 E Sego Lily Dr
Sandy, UT 84092-4350
Phone
(801) 619-9000
Fax
(801) 619-9001
NPI assigned
Jul 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Authorized official

Name
Dr. Christopher S Cutler, MDNPI 1437162013
Title
Physician
Phone
(801) 619-9000

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
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 2901281205 UT Primary

Addresses

Primary practice location

1393 E Sego Lily Dr
Sandy, UT 84092-4350

Mailing address

1393 E Sego Lily Dr
Sandy, UT 84092-4350
Phone (801) 619-9000

Other identifiers 1

IdentifierTypeStateIssuer
DR8477OtherUTPTAN

Other names 1

  • Granite Peaks Gastroenterology Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110420000821 UT Part B Supplier - Clinic/Group Practice 5395920110 Receives reassigned benefits from 13 practitioners
Practice locations: Lehi, UT; Sandy, UT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545955200000",
    "number": "1689872897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1393 E SEGO LILY DR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840924350",
            "telephone_number": "801-619-9000",
            "fax_number": "801-619-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1393 E SEGO LILY DR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840924350",
            "telephone_number": "801-619-9000",
            "fax_number": "801-619-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE PEAKS GI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2018-12-28",
        "status": "A",
        "authorized_official_last_name": "CUTLER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "801-619-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "UT",
            "license": "2901281205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "DR8477",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granite Peaks Gastroenterology",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Granite Peaks Gastroenterology",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.