NPIMap

Organization Active NPI

Integrated Functional Medicine, LLC

Doing business as Integrated Pain Specialists

  • Interventional Pain Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1780451864
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
INTEGRATED FUNCTIONAL MEDICINE, LLC
Doing business as
Integrated Pain Specialists
Practice address
151 E 5600 S Ste 104
Salt Lake City, UT 84107-8140
Phone
(385) 228-4758
NPI assigned
Dec 7, 2023
Last updated
Dec 7, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
INTEGRATED FUNCTIONAL MEDICINE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Authorized official

Name
Kirk WerslandNPI 1558353979
Title
Owner
Phone
(801) 296-8060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X Primary

Addresses

Primary practice location

151 E 5600 S Ste 104
Salt Lake City, UT 84107-8140

Mailing address

151 E 5600 S Ste 104
Salt Lake City, UT 84107-8140
Phone (385) 228-4758

Other names 1

  • Integrated Pain Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140226001532 UT Part B Supplier - Clinic/Group Practice 4789814351 Receives reassigned benefits from 24 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bountiful, UT; Salt Lake City, UT; South Jordan, UT

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Integrated Functional Medicine LLC

Locations

151 E 5600 S
Ste 104
Salt Lake Cty, UT 84107
Phone (801) 495-1064

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1780451864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 E 5600 S STE 104",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841078140",
            "telephone_number": "385-228-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 E 5600 S STE 104",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841078140",
            "telephone_number": "385-228-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED FUNCTIONAL MEDICINE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRATED FUNCTIONAL MEDICINE, LLC",
        "enumeration_date": "2023-12-07",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "WERSLAND",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-296-8060"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrated Pain Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.