NPIMap

Organization Active NPI

Sandman Physician Services PC

  • Anesthesiology Physician
  • North Salt Lake, UT
National Provider Identifier
1760814834
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
75964441205 Issued in UT
Legal business name
SANDMAN PHYSICIAN SERVICES PC
Practice address
637 Sego Lily Cir
North Salt Lake, UT 84054-3355
Phone
(801) 209-7348
NPI assigned
Jul 31, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Authorized official

Name
Dr. Richard L Glines, MD
Title
President
Phone
(801) 209-7348

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X 75964441205 UT Primary
Hospice and Palliative Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LH0002X 75964441205 UT
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 75964441205 UT

Addresses

Primary practice location

637 Sego Lily Cir
North Salt Lake, UT 84054-3355

Mailing address

637 Sego Lily Cir
North Salt Lake, UT 84054-3355

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1760814834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 SEGO LILY CIR",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840543355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 SEGO LILY CIR",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840543355",
            "telephone_number": "801-209-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDMAN PHYSICIAN SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-31",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "GLINES",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-209-7348",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "75964441205",
            "primary": true
        },
        {
            "code": "207LH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Hospice and Palliative Medicine",
            "state": "UT",
            "license": "75964441205",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "UT",
            "license": "75964441205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Salt Lake, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.