Active NPI
Shelley M Lawrence, MD
- Neonatal-Perinatal Medicine Physician
- Salt Lake City, UT
National Provider Identifier
1962567958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 12369074-1205
- Practice address
- 295 S Chipeta Way
Salt Lake City, UT 84108-1287 - Phone
- (801) 581-7052
- NPI assigned
- Dec 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | C131290 | CA | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 21245 | OK | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 12369074-1205 | UT | Primary |
Addresses
Primary practice location
295 S Chipeta Way
Salt Lake City, UT 84108-1287
Mailing address
295 S Chipeta Way
Salt Lake City, UT 84108-1287
Phone (801) 581-7052
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3109577 | Medicaid | CO |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21245 | OK | MD | Clinical Social Worker |
| C131290 | CA | MD | Neonatal-Perinatal Medicine Physician |
| 12369074-1205 | UT | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Pediatric Acuity Care | Current | Accepting new patients | |
| University of Utah Pediatric Acuity Care | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| University of Utah Pediatric Acuity Care | Current | Accepting new patients | |
| University of Utah Pediatric Acuity Care | Neonatal-Perinatal Medicine | Past | Accepting new patients |
Locations
127 S 500 E
Ste 200
Salt Lake City, UT 84102
127 S 500 E
Salt Lake Cty, UT 84102
100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
Interoperability endpoints
- slawrence67724@scrippshlth.medalliesdirect.net
- slawrence533215@direct.med.utah.edu
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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-
- Pediatric Hospice and Palliative Medicine Physician
- Salt Lake City, UT
- NPI 1851898365
-
- General Acute Care Hospital
- San Diego, CA
- NPI 1487928891
-
- Neonatal-Perinatal Medicine Physician
- Salt Lake City, UT
- NPI 1770947814
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659052800000",
"number": "1962567958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "295 S CHIPETA WAY",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081287",
"telephone_number": "801-581-7052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 S CHIPETA WAY",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081287",
"telephone_number": "801-581-7052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAWRENCE",
"first_name": "SHELLEY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-27",
"last_updated": "2022-07-29",
"certification_date": "2022-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "CA",
"license": "C131290",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "OK",
"license": "21245",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "UT",
"license": "12369074-1205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3109577",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.