Organization Active NPI

Immunology Division Department of University of Utah

  • Clinical & Laboratory Immunology (Internal Medicine) Physician
  • Salt Lake City, UT
National Provider Identifier
1891857835
Registry record updated Apr 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical & Laboratory Immunology (Internal Medicine) PhysicianTaxonomy code 207RI0001X
Legal business name
IMMUNOLOGY DIVISION DEPARTMENT OF UNIVERSITY OF UTAH
Practice address
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone
(801) 581-2121
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2009

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

Authorized official

Name
Janell I Madonna
Title
Director of Contracting and Pe
Phone
(801) 587-6464

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Clinical & Laboratory Immunology (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0001X Primary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X

Addresses

Primary practice location

50 N Medical Dr
Salt Lake City, UT 84132-0001

Mailing address

PO Box 413033
Salt Lake City, UT 84141-0001
Phone (801) 213-3800

National Provider Directory

National Provider Directory

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": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239667200000",
    "number": "1891857835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413033",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841410001",
            "telephone_number": "801-213-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMUNOLOGY DIVISION DEPARTMENT OF UNIVERSITY OF UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2009-04-14",
        "status": "A",
        "authorized_official_last_name": "MADONNA",
        "authorized_official_first_name": "JANELL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTING AND PE",
        "authorized_official_telephone_number": "801-587-6464"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical & Laboratory Immunology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Apr 14, 2009; 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.