NPIMap

Organization Active NPI

Brigham Young University

Doing business as BYU Student Health Center

  • Point of Service
  • Provo, UT
National Provider Identifier
1942276092
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
Legal business name
BRIGHAM YOUNG UNIVERSITY
Doing business as
BYU Student Health Center
Practice address
1750 N Wymount Terrace Dr
2300
Provo, UT 84602-4800
Phone
(801) 422-2771
Fax
(801) 422-0764
NPI assigned
Feb 28, 2006
Last updated
Jun 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Dr. D Keith Willmore, M.D.NPI 1861676066
Title
Medical Director
Phone
(801) 422-7443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X NU Primary

Addresses

Primary practice location

1750 N Wymount Terrace Dr
2300
Provo, UT 84602-4800

Mailing address

1750 N Wymount Terrace Dr
2300 SHC
Provo, UT 84602-4800
Phone (801) 422-2771

Other names 1

  • BYU Student Health Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D0679469Brigham Young Univ Student Health Ctr1750 N Wymount Terrace Dr, Provo, UT 84602Certificate of waiverMar 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
Brigham Young University7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1750 N Wymount Terrace Dr
#2300
Provo, UT 84602
Phone (801) 356-0014

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1942276092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 N WYMOUNT TERRACE DR",
            "address_2": "2300 SHC",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846024800",
            "telephone_number": "801-422-2771",
            "fax_number": "801-422-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 N WYMOUNT TERRACE DR",
            "address_2": "2300",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846024800",
            "telephone_number": "801-422-2771",
            "fax_number": "801-422-0764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHAM YOUNG UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "WILLMORE",
        "authorized_official_first_name": "D",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "801-422-7443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BYU Student Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.