NPIMap

Organization Active NPI

Health Clinics of Utah-SLC

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1871654459
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
HEALTH CLINICS OF UTAH-SLC
Practice address
168 N 1950 W Ste 201
Salt Lake City, UT 84116-3007
Phone
(801) 715-3500
Fax
(801) 532-1183
NPI assigned
Dec 13, 2006
Last updated
Jul 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

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

Authorized official

Name
Mr. Steve Ipsen
Title
Clinic Director
Phone
(801) 273-6637

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

168 N 1950 W Ste 201
Salt Lake City, UT 84116-3007

Mailing address

168 N 1950 W Ste 201
Salt Lake City, UT 84116-3007
Phone (801) 715-3500

Other names 1

  • UTAH DEPARTMENT OF HEALTH Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040117000195 UT Part B Supplier - Clinic/Group Practice 6800797333 Receives reassigned benefits from 86 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: American Fork, UT; Ogden, UT; Provo, UT; Salt Lake City, UT

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343260800000",
    "number": "1871654459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 N 1950 W STE 201",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841163007",
            "telephone_number": "801-715-3500",
            "fax_number": "801-532-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 N 1950 W STE 201",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841163007",
            "telephone_number": "801-715-3500",
            "fax_number": "801-532-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CLINICS OF UTAH-SLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2012-07-26",
        "status": "A",
        "authorized_official_last_name": "IPSEN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "801-273-6637",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UTAH DEPARTMENT OF HEALTH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 26, 2012; 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.