Organization Active NPI

Sara a. Wells, M.D., a Professional Corporation

Doing business as parleys medical

  • Family Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1821225079
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
953098541205 Issued in UT
Legal business name
SARA A. WELLS, M.D., A PROFESSIONAL CORPORATION
Doing business as
parleys medical
Practice address
2131 E 2100 S
Salt Lake City, UT 84109-1128
Phone
(801) 474-0355
Fax
(801) 485-8007
NPI assigned
Jun 15, 2009
Organization subpart
Yes
Parent organization
SARA A. WELLS, M.D. A PROFESSIONAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Authorized official

Name
Sara A Wells, MDNPI 1528164621
Title
President
Phone
(801) 474-0355

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 953098541205 UT Primary
Primary Care Clinic/Center 261QP2300X 953098541205 UT

Addresses

Primary practice location

2131 E 2100 S
Salt Lake City, UT 84109-1128

Mailing address

2131 E 2100 S
Salt Lake City, UT 84109-1128
Phone (801) 474-0355

Other identifiers 2

IdentifierTypeStateIssuer
528395226006MedicaidUT
DP8219OtherUTRR MEDICARE

Other names 1

  • parleys medical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090618000692 UT Part B Supplier - Clinic/Group Practice 0042361735 Receives reassigned benefits from 1 practitioner
Practice locations: Salt Lake City, UT

National Provider Directory

National Provider Directory
Part of
Sara a Wells MD a Prof Corp

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1821225079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 E 2100 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841091128",
            "telephone_number": "801-474-0355",
            "fax_number": "801-485-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 E 2100 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841091128",
            "telephone_number": "801-474-0355",
            "fax_number": "801-485-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARA A. WELLS, M.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SARA A. WELLS, M.D. A PROFESSIONAL CORPORATION",
        "enumeration_date": "2009-06-15",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-474-0355",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "953098541205",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "UT",
            "license": "953098541205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528395226006",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DP8219",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "parleys medical",
            "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 Mar 26, 2014; 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.