Rebecca Jane Purtell, M.D.
Individual provider Active NPI Pediatrics Physician · Salt Lake City, UT
NPI 1902168677 · NPPES record last updated Dec 20, 2021
Key facts
- NPI
- 1902168677
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MT202174 (PA)
- Practice address
- 100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103 - Phone
- (801) 662-3645
- NPI assigned
- Jun 8, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150812006860 | UT | Practitioner - Pediatric Medicine | 9335454982 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT202174 | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Pediatric Services | Pediatrics | Current | Accepting new patients |
| University of Utah Pediatric Services | Pediatrics | Current |
Accepting new patients |
| University of Utah Pediatric Services | Current |
Accepting new patients |
Locations
3741 W 12600 S
Riverton, UT 84065
Phone (801) 285-2400
127 S 500 E
Salt Lake Cty, UT 84102
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109
Interoperability endpoints
- rpurtell524753@direct.med.utah.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MT202174 | PA | Yes |
Addresses
Primary practice location
100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Mailing address
100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (801) 662-3645
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | RPURTELL524753@DIRECT.MED.UTAH.EDU | Direct | University of Utah |
Other providers in Salt Lake City, UT
- Pure Dermatology LLC
- Pure Infusion Suites, LLC
- Jessica Dawn Purkey
- Courtney Anne Pursell
- Dean Purser
- Push Concierge Medicine, PLLC
- Richard Isaac Pushkin
- Amy Putich
- Stanford S. Putman
- Summer Putman
All providers in Salt Lake City, UT · Pediatrics Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.