Individual provider Active NPI

Stephen L Guthery

  • Pediatrics Physician
  • Salt Lake City, UT
National Provider Identifier
1801975370
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5108128-1205 Issued in UT
Practice address
100 N Medical Dr
Salt Lake City, UT 84113-1103
Phone
(801) 581-2121
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5108128-1205 UT Primary

Addresses

Primary practice location

100 N Medical Dr
Salt Lake City, UT 84113-1103

Mailing address

PO Box 581100
Salt Lake City, UT 84158-1100
Phone (801) 213-3800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sguthery119411@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050610000756 UT Practitioner - Pediatric Medicine 0749224707 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5108128-1205UTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Services CurrentSince Mar 1, 2024 Accepting new patients
University of Utah Pediatric Services Pediatrics Current Accepting new patients
University of Utah Pediatric Services CurrentSince Mar 1, 2024 Accepting new patients
University of Utah Pediatric Services Pediatrics Past Accepting new patients
Department of Pediatrics University of Utah Pediatrics Past Accepting new patients

Locations

2985 Cortez Ave
Idaho Falls, ID 83404
Phone (208) 522-4600

81 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 662-5700

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

Interoperability endpoints

  • Direct secure messaging: sguthery119411@direct.med.utah.edu

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1801975370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 581100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841581100",
            "telephone_number": "801-213-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTHERY",
        "first_name": "STEPHEN",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "5108128-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sguthery119411@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.