Organization Active NPI

Obstetrics and Gynecology Clinic, Inc.

  • Obstetrics & Gynecology Physician
  • Salt Lake City, UT
National Provider Identifier
1851489876
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
OBSTETRICS AND GYNECOLOGY CLINIC, INC.
Practice address
850 E 300 S
Suite 1
Salt Lake City, UT 84102-2332
Phone
(801) 322-1214
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Kimberly Cameron
Title
Office Manager
Phone
(801) 531-6109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X UT Primary

Addresses

Primary practice location

850 E 300 S
Suite 1
Salt Lake City, UT 84102-2332

Mailing address

850 E 300 S
Suite 1
Salt Lake City, UT 84102-2332
Phone (801) 322-1214

Other identifiers 2

IdentifierTypeStateIssuer
46D0704114OtherUTCLIA
05350MedicaidUT

National Provider Directory

National Provider Directory

Locations

850 E 300 S
Ste 1
Salt Lake Cty, UT 84102
Phone (385) 429-9808

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": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1851489876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 E 300 S",
            "address_2": "SUITE 1",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022332",
            "telephone_number": "801-322-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E 300 S",
            "address_2": "SUITE 1",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022332",
            "telephone_number": "801-322-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSTETRICS AND GYNECOLOGY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CAMERON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-531-6109"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "46D0704114",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05350",
            "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 Jul 21, 2022; 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.