NPIMap

Organization Active NPI

Ivora Inc

  • Primary Care Clinic/Center
  • Draper, UT
National Provider Identifier
1952902850
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
IVORA INC
Practice address
13894 S Bangerter Pkwy Ste 200
Draper, UT 84020-5320
Phone
(801) 901-3603
NPI assigned
Nov 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Authorized official

Name
Stephen M Fabiano
Title
Ceo
Phone
(954) 702-3372

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X

Addresses

Primary practice location

13894 S Bangerter Pkwy Ste 200
Draper, UT 84020-5320

Mailing address

10885 S Lostwood Dr
Sandy, UT 84092-4925
Phone (954) 702-3372

Other names 1

  • Fia Care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1952902850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10885 S LOSTWOOD DR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840924925",
            "telephone_number": "954-702-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13894 S BANGERTER PKWY STE 200",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205320",
            "telephone_number": "801-901-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVORA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-06",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "FABIANO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-702-3372"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fia Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fia Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.