NPIMap

Organization Active NPI

Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
National Provider Identifier
1760944243
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PHYSICIAN GROUP OF UTAH INC
Practice address
406 W South Jordan Pkwy Ste 500
South Jordan, UT 84095-3945
Phone
(801) 984-3418
Fax
(801) 984-3479
NPI assigned
Apr 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Authorized official

Name
Tyler K Wilko
Title
Ceo
Phone
(801) 984-3293

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

406 W South Jordan Pkwy Ste 500
South Jordan, UT 84095-3945

Mailing address

PO Box 281415
Atlanta, GA 30384-1415
Phone (800) 673-1270

Other names 1

  • STEWARD MEDICAL GROUP OF UTAH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Physician Group of Utah Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

406 W South Jordan Pkwy
Ste 500
South Jordan, UT 84095
Phone (801) 984-3400

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554249600000",
    "number": "1760944243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 281415",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841415",
            "telephone_number": "800-673-1270",
            "fax_number": "314-432-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 W SOUTH JORDAN PKWY STE 500",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840953945",
            "telephone_number": "801-984-3418",
            "fax_number": "801-984-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN GROUP OF UTAH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-03",
        "last_updated": "2019-04-03",
        "status": "A",
        "authorized_official_last_name": "WILKO",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-984-3293"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STEWARD MEDICAL GROUP OF UTAH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.