NPIMap

Organization Active NPI

University of Utah Community Physicians Group

Doing business as UUHC- Centerville Clinic

  • Family Medicine Physician
  • Centerville, UT
National Provider Identifier
1699179267
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNIVERSITY OF UTAH COMMUNITY PHYSICIANS GROUP
Doing business as
UUHC- Centerville Clinic
Practice address
26 S Main St
Centerville, UT 84014-1817
Phone
(801) 693-7900
NPI assigned
Oct 10, 2014
Last updated
Oct 10, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF UTAH COMMUNITY PHYSICIANS GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

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

Authorized official

Name
Sean Mulvihill, MD
Title
Chief Medical Officer
Phone
(801) 587-6336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

26 S Main St
Centerville, UT 84014-1817

Mailing address

PO Box 510708
Salt Lake City, UT 84151-0708
Phone (801) 213-3900

Other names 1

  • UUHC- Centerville Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150126002118 UT Part B Supplier - Clinic/Group Practice 9739403569 Receives reassigned benefits from 411 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salt Lake City, UT

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Part of
University of Utah Community Physicians Group

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412899200000",
    "number": "1699179267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510708",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841510708",
            "telephone_number": "801-213-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 S MAIN ST",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840141817",
            "telephone_number": "801-693-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH COMMUNITY PHYSICIANS GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF UTAH COMMUNITY PHYSICIANS GROUP",
        "enumeration_date": "2014-10-10",
        "last_updated": "2014-10-10",
        "status": "A",
        "authorized_official_last_name": "MULVIHILL",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "801-587-6336",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UUHC- Centerville Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centerville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.