Ucfa Physicians Network Group of Ut

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

UCFA PHYSICIANS NETWORK GROUP OF UT

Doing business as

PNG Utah

Practice address

159 W Broadway
Salt Lake City, UT 84101-1907

Phone

(865) 307-3441

Fax

(865) 409-2526

NPI assigned

Dec 5, 2017

Last updated

Oct 5, 2021By 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

Mr. Theo S Stephens, CMA

Title

Chief Operations Officer

Phone

(423) 271-9911

Specialties & licenses 1

Addresses

Other names 1

• PNG Utah Doing business as

Locations

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1902311558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8930 CROSS PARK DR STE 3",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234713",
            "telephone_number": "423-271-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 W BROADWAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841011907",
            "telephone_number": "865-307-3441",
            "fax_number": "865-409-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCFA PHYSICIANS NETWORK GROUP OF UT",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "THEO",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "423-271-9911",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CMA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PNG Utah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• U-U Noninvasive Vascular Lab
• U-U Pediatric Dermatology
• U-U Pulmonary Division
• U-U Rehabilitation Medicine
• U-U Rheumatology Division
• Derek Akio Uchida
• Kimberly Akimi Uchida
• Evie Uchino-Llenos
• Dustyn Hiroshi Uchiyama, MD
• Clifton Rueben Uckerman, LCSW

• Internal Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Internal Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.