NPIMap

Organization Active NPI

Utah Podiatry Group PC

  • Foot & Ankle Surgery Podiatrist
  • Taylorsville, UT
National Provider Identifier
1700369014
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
UTAH PODIATRY GROUP PC
Practice address
6321 S Redwood Rd Ste 102
Taylorsville, UT 84123-6799
Phone
(801) 505-5277
Fax
(801) 505-5280
NPI assigned
Sep 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Authorized official

Name
Scott A Clark
Title
DPM
Phone
(801) 505-5277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

6321 S Redwood Rd Ste 102
Taylorsville, UT 84123-6799

Mailing address

24 S 1100 E Ste 210
Salt Lake City, UT 84102-1580
Phone (801) 505-5277

Other identifiers 1

IdentifierTypeStateIssuer
106339-0501OtherUTLICENSE

Other names 1

  • Advanced Foot And Ankle Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Utah Podiary Group PC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587427200000",
    "number": "1700369014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 S 1100 E STE 210",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021580",
            "telephone_number": "801-505-5277",
            "fax_number": "801-505-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6321 S REDWOOD RD STE 102",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841236799",
            "telephone_number": "801-505-5277",
            "fax_number": "801-505-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH PODIATRY GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-12",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "801-505-5277"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "106339-0501",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Foot And Ankle Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taylorsville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.