Medicruiser Onsite Care

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

97-339160-1205 Issued in UT

Legal business name

MEDICRUISER ONSITE CARE

Practice address

225 10TH Ave
Salt Lake City, UT 84103-2529

Phone

(801) 484-5504

Fax

(801) 484-5538

NPI assigned

May 1, 2012

Last updated

Feb 28, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Gahlinger

Title

Billing Manager

Phone

(801) 484-5504

Specialties & licenses 1

Addresses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8403/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1710245402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 10TH AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032529",
            "telephone_number": "801-484-5504",
            "fax_number": "801-484-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 10TH AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032529",
            "telephone_number": "801-484-5504",
            "fax_number": "801-484-5538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICRUISER ONSITE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-01",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "GAHLINGER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "801-484-5504"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "UT",
            "license": "97-339160-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medicor, LLC
• Medicruiser, LLC
• Anthony David Medina
• Janet Medina
• Lisa Ann Medina
• Maryanne Medina

• Geriatric Medicine (Family Medicine) Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Geriatric Medicine (Family Medicine) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; 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.