Neurology Specialty Clinic, PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

1706651205 Issued in UT

Legal business name

NEUROLOGY SPECIALTY CLINIC, PLLC

Practice address

11762 S State St
Ste 333
Draper, UT 84020-7155

Phone

(801) 473-7035

Fax

(801) 607-1467

NPI assigned

May 2, 2013

Organization subpart

No

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

Authorized official

Name

Karen Watkins, RN

Title

Billing Manager

Phone

(801) 473-7035

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1861837924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970802",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840970802",
            "telephone_number": "801-473-7035",
            "fax_number": "801-607-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11762 S STATE ST",
            "address_2": "STE 333",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207155",
            "telephone_number": "801-473-7035",
            "fax_number": "801-607-1467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY SPECIALTY CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-02",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "801-473-7035",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "UT",
            "license": "1706651205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Draper, UT
• Providers in Draper, UT by specialty
• Medical Specialty Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; 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.