Mt. Timpanogas Fertility & Endocrinology, PLLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

Legal business name

MT. TIMPANOGAS FERTILITY & ENDOCRINOLOGY, PLLC

Practice address

880 E 9400 S Ste 112
Sandy, UT 84094-4134

Phone

(801) 938-9627

Fax

(801) 666-6915

NPI assigned

Jul 7, 2015

Last updated

Nov 3, 2015By 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

Hansel Rayner

Title

Owner

Phone

(801) 938-9627

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1871976985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 E 9400 S STE 112",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840944134",
            "telephone_number": "801-938-9627",
            "fax_number": "801-666-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 E 9400 S STE 112",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840944134",
            "telephone_number": "801-938-9627",
            "fax_number": "801-666-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT. TIMPANOGAS FERTILITY & ENDOCRINOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "RAYNER",
        "authorized_official_first_name": "HANSEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-938-9627"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "6814504-1206",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356319842",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1356319842",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gynecology Physician in Sandy, UT
• Providers in Sandy, UT by specialty
• Gynecology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.