Active NPI
Utah Spine Care, LLC
Doing business as Utah Spine Care
- Neurological Surgery Physician
- Ogden, UT
National Provider Identifier
1700173473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 2626351205
- Legal business name
- UTAH SPINE CARE, LLC
- Doing business as
- Utah Spine Care
- Practice address
- 4403 Harrison Blvd
Ste 1815
Ogden, UT 84403-3271 - Phone
- (801) 732-5950
- Fax
- (801) 732-5988
- NPI assigned
- Jul 1, 2011
- Last updated
- Oct 3, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Troy Fuller
- Title
- Practice Administrator
- Phone
- (801) 732-5950
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 1835611205 | UT | |
| Neurological Surgery Physician | 207T00000X | 2626351205 | UT | Primary |
| Physical Medicine & Rehabilitation Physician | 208100000X | 1765801205 | UT |
Addresses
Primary practice location
4403 Harrison Blvd
Ste 1815
Ogden, UT 84403-3271
Mailing address
4403 Harrison Blvd
Ste 1815
Ogden, UT 84403-3271
Phone (801) 732-5950
Other names 1
- Utah Spine Care
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
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.
-
- Neurological Surgery Physician
- Ogden, UT
- NPI 1194769604
-
- Pain Medicine Physician
- Ogden, UT
- NPI 1255339552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309478400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1475452800000",
"number": "1700173473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4403 HARRISON BLVD",
"address_2": "STE 1815",
"city": "OGDEN",
"state": "UT",
"postal_code": "844033271",
"telephone_number": "801-732-5950",
"fax_number": "801-732-5988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4403 HARRISON BLVD",
"address_2": "STE 1815",
"city": "OGDEN",
"state": "UT",
"postal_code": "844033271",
"telephone_number": "801-732-5950",
"fax_number": "801-732-5988"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UTAH SPINE CARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-07-01",
"last_updated": "2016-10-03",
"status": "A",
"authorized_official_last_name": "FULLER",
"authorized_official_first_name": "TROY",
"authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
"authorized_official_telephone_number": "801-732-5950"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "UT",
"license": "1835611205",
"primary": false
},
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "UT",
"license": "2626351205",
"primary": true
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "UT",
"license": "1765801205",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Utah Spine Care",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.