Olympus Spine and Pain

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

OLYMPUS SPINE AND PAIN

Practice address

2630 E Venus Cir
Holladay, UT 84124-1846

Phone

(801) 425-8794

NPI assigned

Apr 5, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Keith Warner, MDNPI 1164849527

Title

Owner

Phone

(801) 425-8794

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26577/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keith B Warner, MD

  • Anesthesiology Physician
  • Murray, UT
  • NPI 1164849527
  Medicare reassignment Care Compare group NPD Authorized official
• Judith Sawaya Sampson, APRN

  • Family Nurse Practitioner
  • Salt Lake City, UT
  • NPI 1538112214
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1720729437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 E VENUS CIR",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841241846",
            "telephone_number": "801-425-8794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 E VENUS CIR",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841241846",
            "telephone_number": "801-425-8794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPUS SPINE AND PAIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A",
        "authorized_official_last_name": "WARNER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-425-8794",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard T. O'Brien, M.D.
• Thomas J J Oberg, M.D.
• Oculoplastic Surgery, Inc.
• Tara Jill Olson
• Olympus Health and Performance
• Oral Design Dental
• Emily Ann Osisek
• Jeffrey Todd Owens, DC
• Michelle Owens, DPT, ATC
• P I C Incorporated

• Pain Medicine Physician in Holladay, UT
• Providers in Holladay, UT by specialty
• Pain Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.