NPIMap

Organization Active NPI

Mountain West Ear Nose and Throat LC

  • Otolaryngology Physician
  • Bountiful, UT
National Provider Identifier
1770631194
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
264339-1205 Issued in UT
Legal business name
MOUNTAIN WEST EAR NOSE AND THROAT LC
Practice address
1551 Renaissance Towne Dr
Suite 310
Bountiful, UT 84010-7667
Phone
(801) 295-5581
Fax
(801) 295-9253
NPI assigned
Jan 8, 2007
Last updated
Aug 5, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Authorized official

Name
Dr. Curt R Stock, M.D.NPI 1275681686
Title
Gen.
Phone
(801) 295-5581

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 178486-1205 UT
Otolaryngology Physician 207Y00000X 188579-1205 UT
Otolaryngology Physician 207Y00000X 5395A WY
Otolaryngology Physician 207Y00000X 5387A WY
Otolaryngology Physician 207Y00000X 264339-1205 UT Primary
Pediatric Otolaryngology Physician 207YP0228X 182660-1205 UT

Addresses

Primary practice location

1551 Renaissance Towne Dr
Suite 310
Bountiful, UT 84010-7667

Mailing address

2255 N 1700 W
Suite 200
Layton, UT 84041-1140
Phone (801) 776-2180

Other identifiers 3

IdentifierTypeStateIssuer
124257100MedicaidWY
DA4984OtherUTRAILROAD MEDICARE
108796700MedicaidWY

National Provider Directory

National Provider Directory

Locations

425 Medical Dr
#205
Bountiful, UT 84010
Phone (801) 295-5581

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1770631194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 N 1700 W",
            "address_2": "SUITE 200",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411140",
            "telephone_number": "801-776-2180",
            "fax_number": "801-776-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 RENAISSANCE TOWNE DR",
            "address_2": "SUITE 310",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107667",
            "telephone_number": "801-295-5581",
            "fax_number": "801-295-9253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN WEST EAR NOSE AND THROAT LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "STOCK",
        "authorized_official_first_name": "CURT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "GEN.",
        "authorized_official_telephone_number": "801-295-5581",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "178486-1205",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "188579-1205",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WY",
            "license": "5395A",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WY",
            "license": "5387A",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "264339-1205",
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "UT",
            "license": "182660-1205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124257100",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA4984",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108796700",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.