Individual provider Active NPI

Shelley M Lawrence, MD

  • Neonatal-Perinatal Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1962567958
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
12369074-1205 Issued in UT
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

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3109577MedicaidCO

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210727003147 UT Practitioner - Pediatric Medicine 4688705510 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21245OKMDClinical Social Worker
C131290CAMDNeonatal-Perinatal Medicine Physician
12369074-1205UTMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Acuity Care Current Accepting new patients
University of Utah Pediatric Acuity Care CurrentSince Jul 15, 2021 Accepting new patients
Scripps Health Current Accepting new patients
University of Utah Pediatric Acuity Care CurrentSince Jul 15, 2021 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

  • Direct secure messaging: slawrence67724@scrippshlth.medalliesdirect.net
  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.