Individual provider Active NPI

Victoria Stanger, PA-C

  • Family Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1821165424
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
176411-1206 Issued in UT
Practice address
1291 N 1500 W
Salt Lake City, UT 84116-1644
Phone
(801) 531-7217
NPI assigned
Nov 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 176411-1206 UT Primary

Addresses

Primary practice location

1291 N 1500 W
Salt Lake City, UT 84116-1644

Mailing address

1291 N 1500 W
Salt Lake City, UT 84116-1644
Phone (801) 531-7217

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140402000500 UT Practitioner - Physician Assistant 7012148216 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
176411-1206UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Utah CurrentSince Jan 13, 2014 Accepting new patients
Health Clinics of Utah-SLC CurrentSince Jan 13, 2014 Accepting new patients

Locations

168 N 1950 W
Ste 201
Slc, UT 84116
Phone (801) 213-2537

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821165424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1291 N 1500 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841161644",
            "telephone_number": "801-531-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1291 N 1500 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841161644",
            "telephone_number": "801-531-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANGER",
        "first_name": "VICTORIA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "176411-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.