NPIMap

Organization Active NPI

Western Newborn Specialists

  • Pediatrics Physician
  • Salt Lake City, UT
National Provider Identifier
1841271558
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
13593400144 Issued in UT
Legal business name
WESTERN NEWBORN SPECIALISTS
Practice address
1200 E 3900 S
Salt Lake City, UT 84124
Phone
(801) 296-2113
Fax
(801) 951-2389
NPI assigned
Nov 9, 2005
Last updated
Nov 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Authorized official

Name
Ellen Liu, MDNPI 1790784965
Title
V President
Phone
(801) 296-2113

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
Pediatrics Physician 208000000X 13593400144 UT Primary

Addresses

Primary practice location

1200 E 3900 S
Salt Lake City, UT 84124

Mailing address

PO Box 520691
Salt Lake City, UT 84152
Phone (801) 296-2113

Other identifiers 2

IdentifierTypeStateIssuer
118584500MedicaidWY
1841271558MedicaidUT

National Provider Directory

National Provider Directory
Tax ID family
Western Newborn Specialists2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1841271558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520691",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84152",
            "telephone_number": "801-296-2113",
            "fax_number": "801-951-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84124",
            "telephone_number": "801-296-2113",
            "fax_number": "801-951-2389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN NEWBORN SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "V PRESIDENT",
        "authorized_official_telephone_number": "801-296-2113",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "13593400144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118584500",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841271558",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 2, 2011; 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.