Audie Christopher Espinoza, M.D.

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

101890 Issued in MT

Practice address

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103

Phone

(801) 587-7575

NPI assigned

Jun 9, 2015

Last updated

Sep 30, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aespinoza149160@direct.med.utah.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Utah Pediatric Services

  dba Department of Pediatrics

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1487018974
  Medicare reassignment NPD
• Shriners Hospitals for Children

  • Pediatric Orthopaedic Surgery Physician
  • Salt Lake City, UT
  • NPI 1396187282
  Medicare reassignment
• Shriners Hospitals for Children

  • Anesthesiology Physician
  • Salt Lake City, UT
  • NPI 1528556776
  NPD
• University of Utah Pediatric Services

  dba Pediatric Infectious Disease

  • Pediatric Infectious Diseases Physician
  • Salt Lake City, UT
  • NPI 1285098855
  NPD
• University of Utah Pediatric Services

  dba Pediatric Genetics

  • Clinical Genetics (M.D.) Physician
  • Salt Lake City, UT
  • NPI 1861856619
  NPD
• Ambulatory Neurological Services, LLC

  • Electroneurodiagnostic Specialist/Technologist
  • West Jordan, UT
  • NPI 1154631505
  NPD (past)
• University of Utah Pediatric Services

  dba Pediatric Inpatient Services Riverton

  • Pediatrics Physician
  • Riverton, UT
  • NPI 1043671985
  NPD (past)
• Ambulatory Neurological Services, LLC

  • EEG Technician
  • Boise, ID
  • NPI 1578800116
  NPD (past)

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1912387598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 E 3RD AVE APT 5",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032788",
            "telephone_number": "214-738-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-587-7575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 26th St S",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594055161",
            "country_code": "US",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESPINOZA",
        "first_name": "AUDIE",
        "middle_name": "CHRISTOPHER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-09",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "TX",
            "license": "26632820",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MT",
            "license": "101890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aespinoza149160@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mana Espahbodi, MD
• Jose Luis Esparza, FNP
• Carl Jeffersonn Esperanzate
• Evelia Espericueta
• Ace Derick Espinosa
• Corinne Ruth Espinoza, PHD
• Freddy Alexander Espinoza
• Liliana Espinoza
• Valynn Espinoza, LCSW
• Gregory Therel Esplin

• Neurology with Special Qualifications in Child Neurology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.