NPIMap

Organization Active NPI

Salt Lake Orthopaedic Specialist, LLC

Doing business as Salt Lake Orthopaedic Clinic

  • Specialist
  • Salt Lake City, UT
National Provider Identifier
1811913429
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
5211 Issued in UT
Legal business name
SALT LAKE ORTHOPAEDIC SPECIALIST, LLC
Doing business as
Salt Lake Orthopaedic Clinic
Practice address
1521 E 3900 S Ste 200
Salt Lake City, UT 84124-1501
Phone
(801) 262-8486
Fax
(801) 284-8699
NPI assigned
Jul 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Brent A Felix, M.D.NPI 1851383350
Title
President
Phone
(801) 262-8486

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
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 5211 UT Primary

Addresses

Primary practice location

1521 E 3900 S Ste 200
Salt Lake City, UT 84124-1501

Mailing address

280 S Main St
Bountiful, UT 84010-6236
Phone (801) 505-0821

Other practice location 1

2326 N 400 E Ste 102
Tooele, UT 84074-3460
Phone (435) 241-6444

Other names 1

  • Salt Lake Orthopaedic Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040102000837 UT Part B Supplier - Clinic/Group Practice 3173422730 Receives reassigned benefits from 14 practitioners
Practice locations: Orem, UT; Tooele, UT; Salt Lake City, UT; American Fork, UT
O20100930048470 UT DME Supplier - Physician - Orthopedic/Orthopedic Surgery 3173422730 Practice locations: Salt Lake City, UT

National Provider Directory

National Provider Directory

Locations

1521 E 3900 S
Ste 200
Salt Lake City, UT 84124
Phone (801) 262-8486

3715 W 4100 S
West Valley City, UT 84120
Phone (801) 329-0402

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1811913429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 S MAIN ST",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106236",
            "telephone_number": "801-505-0821",
            "fax_number": "801-505-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 E 3900 S STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241501",
            "telephone_number": "801-262-8486",
            "fax_number": "801-284-8699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2326 N 400 E Ste 102",
            "address_purpose": "LOCATION",
            "city": "Tooele",
            "state": "UT",
            "postal_code": "840743460",
            "country_code": "US",
            "telephone_number": "435-241-6444",
            "fax_number": "435-615-8823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SALT LAKE ORTHOPAEDIC SPECIALIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "FELIX",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-262-8486",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "UT",
            "license": "5211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Salt Lake Orthopaedic Clinic",
            "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 Aug 28, 2024; 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.