David R Boettger MD PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

172331-1205 Issued in UT

Legal business name

DAVID R BOETTGER MD PC

Practice address

9720 S 1300 E
Sandy, UT 84094-3712

Phone

(801) 572-6700

Fax

(801) 571-0081

NPI assigned

Nov 18, 2016

Organization subpart

No

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

Authorized official

Name

David R Boettger, MD

Title

MD and Owner

Phone

(801) 572-6700

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1479427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481846400000",
    "number": "1700329091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9720 S 1300 E",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840943712",
            "telephone_number": "801-572-6700",
            "fax_number": "801-571-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9720 S 1300 E",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840943712",
            "telephone_number": "801-572-6700",
            "fax_number": "801-571-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID R BOETTGER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-18",
        "last_updated": "2016-12-16",
        "status": "A",
        "authorized_official_last_name": "BOETTGER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MD AND OWNER",
        "authorized_official_telephone_number": "801-572-6700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "172331-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254761047064",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Sandy, UT
• Providers in Sandy, UT by specialty
• Pediatrics Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.