Individual provider Active NPI

Diantha Williamson, M.D.

  • Family Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1720467780
Registry record updated Aug 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9854067-1205 Issued in UT
Practice address
1250 E 3900 S Ste 260
Salt Lake City, UT 84124-1371
Phone
(801) 265-2000
Fax
(801) 265-2008
NPI assigned
May 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9854067-1205 UT Primary

Addresses

Primary practice location

1250 E 3900 S Ste 260
Salt Lake City, UT 84124-1371

Mailing address

1250 E 3900 S Ste 260
Salt Lake City, UT 84124-1371
Phone (801) 265-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180123000366 UT Practitioner - Family Practice 8325345036 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

9450 S 1300
Sandy, UT 84094-5555
Phone (801) 501-6500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9854067-1205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Physician Group of Utah Inc CurrentSince Jan 15, 2018 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jul 26, 2023 Accepting new patients
Ihc Health Services Inc CurrentSince Jul 26, 2023 Accepting new patients
Granger Medical Specialists LLC Past Accepting new patients
Utah Healthcare Institute Inc Family Medicine PastSince Jul 1, 2000 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

9450 S 1300 E
Sandy, UT 84094
Phone (801) 501-2133

389 S 900 E
Slc, UT 84102
Phone (385) 282-2000

5360 S 2700 W
Taylorsville, UT 84129
Phone (801) 262-5711

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1432339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1720467780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S STE 260",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241371",
            "telephone_number": "801-265-2000",
            "fax_number": "801-265-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S STE 260",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241371",
            "telephone_number": "801-265-2000",
            "fax_number": "801-265-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "DIANTHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-23",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9854067-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.