Individual provider Active NPI

Susan Abu-Khalaf, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Salt Lake City, UT
National Provider Identifier
1891906541
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
5747023-1205 Issued in UT
Practice address
470 East 3900 South
#200
Salt Lake City, UT 84107-2332
Phone
(801) 747-2800
Fax
(801) 747-3022
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 5747023-1205 UT Primary

Addresses

Primary practice location

470 East 3900 South
#200
Salt Lake City, UT 84107-2332

Mailing address

PO Box 571800
Murray, UT 84157-1800
Phone (801) 747-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1891906541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 571800",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841571800",
            "telephone_number": "801-747-2800",
            "fax_number": "801-747-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 EAST 3900 SOUTH",
            "address_2": "#200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072332",
            "telephone_number": "801-747-2800",
            "fax_number": "801-747-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABU-KHALAF",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "UT",
            "license": "5747023-1205",
            "primary": true
        }
    ],
    "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 Jul 21, 2010; 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.