NPIMap

Organization Active NPI

ENT Professional Association Services

  • Otolaryngology Physician
  • SLC, UT
National Provider Identifier
1801857271
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
5239 Issued in UT
Legal business name
ENT PROFESSIONAL ASSOCIATION SERVICES
Practice address
4000 S 700 E
Ste 10
SLC, UT 84107-2180
Phone
(801) 268-4141
Fax
(801) 261-8609
NPI assigned
Mar 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Authorized official

Name
Jerry W Sonkens, M.D.
Title
President
Phone
(801) 268-4141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 5239 UT Primary

Addresses

Primary practice location

4000 S 700 E
Ste 10
SLC, UT 84107-2180

Mailing address

4000 S 700 E
Ste 10
SLC, UT 84107-2180
Phone (801) 268-4141

Other names 1

  • ENT SPECIALISTS LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050318000500 UT Part B Supplier - Clinic/Group Practice 8921053349 Receives reassigned benefits from 19 practitioners
Practice locations: West Jordan, UT; Tooele, UT; Salt Lake City, UT; Murray, UT; Draper, UT

National Provider Directory

National Provider Directory

Locations

96 E Kimballs Ln
Ste 309
Draper, UT 84020
Phone (801) 260-3687

4000 S 7th E
Ste 10
Salt Lake Cty, UT 84107
Phone (801) 268-4141

5770 S 250 E
Ste 475
Salt Lake Cty, UT 84107
Phone (801) 268-6900

5770 S 250 E
Ste 285
Salt Lake Cty, UT 84107
Phone (801) 268-2822

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1801857271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 S 700 E",
            "address_2": "STE 10",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841072180",
            "telephone_number": "801-268-4141",
            "fax_number": "801-261-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 S 700 E",
            "address_2": "STE 10",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841072180",
            "telephone_number": "801-268-4141",
            "fax_number": "801-261-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT PROFESSIONAL ASSOCIATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "SONKENS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-268-4141",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "5239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ENT SPECIALISTS LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in SLC, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.