Intermountain Spine Partners

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

Legal business name

INTERMOUNTAIN SPINE PARTNERS

Doing business as

Intermountain Spine Institute

Practice address

5770 South 250 East
Suite 135
Salt Lake City, UT 84107-8241

Phone

(801) 314-2225

Fax

(801) 314-2345

NPI assigned

Mar 3, 2016

Last updated

Mar 3, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Reed Eugene Fogg, M.D.NPI 1881663870

Title

Director

Phone

(801) 314-2225

Specialties & licenses 3

Addresses

Other names 1

• Intermountain Spine Institute Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Reed Fogg, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Salt Lake City, UT
  • NPI 1881663870
  Authorized official Same address or phone

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1821458878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5770 SOUTH 250 EAST",
            "address_2": "SUITE 135",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841078241",
            "telephone_number": "801-314-2225",
            "fax_number": "801-314-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 SOUTH 250 EAST",
            "address_2": "SUITE 135",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841078241",
            "telephone_number": "801-314-2225",
            "fax_number": "801-314-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN SPINE PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "FOGG",
        "authorized_official_first_name": "REED",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "801-314-2225",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Spine Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intermountian Lipid Center
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• Internal Med- Cardiology- Ep- Dept of University of Utah
• Internal Med- Hematology- Hematologic Department of University of Utah

• Orthopaedic Surgery of the Spine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Orthopaedic Surgery of the Spine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.