NPIMap

Organization Active NPI

Ivan D Flint MD PC

  • Clinic/Center
  • SLC, UT
National Provider Identifier
1821271529
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
3200011205 Issued in UT
Legal business name
IVAN D FLINT MD PC
Practice address
1250 E 3900 S Ste 450
SLC, UT 84124-1349
Phone
(801) 262-3600
Fax
(801) 206-2555
NPI assigned
Dec 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Authorized official

Name
Ivan D Flint, MDNPI 1962484485
Title
MD/ President
Phone
(801) 262-3600

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
Clinic/Center 261Q00000X 3200011205 UT Primary

Addresses

Primary practice location

1250 E 3900 S Ste 450
SLC, UT 84124-1349

Mailing address

1250 E 3900 S Ste 450
SLC, UT 84124-1349
Phone (801) 262-3600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050805000563 UT Part B Supplier - Clinic/Group Practice 9830128222 Receives reassigned benefits from 4 practitioners
Practice locations: Salt Lake Cty, UT

National Provider Directory

National Provider Directory

Locations

602 E Fort Union Blvd
Midvale, UT 84047
Phone (801) 313-1010

1250 E 3900 S
Ste 450
Slc, UT 84124
Phone (801) 262-3600

255 S 100 E
Ste 201
Tooele, UT 84074
Phone (435) 843-9779

Practitioners & affiliated clinicians

Practitioners 6

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": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1821271529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S STE 450",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841241349",
            "telephone_number": "801-262-3600",
            "fax_number": "801-206-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S STE 450",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841241349",
            "telephone_number": "801-262-3600",
            "fax_number": "801-206-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVAN D FLINT MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "FLINT",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MD/ PRESIDENT",
        "authorized_official_telephone_number": "801-262-3600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "UT",
            "license": "3200011205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 17, 2007; 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.