Nicholas J. Paulk MD, PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

7872137-1205 Issued in UT

Legal business name

NICHOLAS J. PAULK MD, PC

Practice address

1521 E 3900 S Ste 100
Salt Lake City, UT 84124-1550

Phone

(801) 268-3800

Fax

(801) 268-3997

NPI assigned

Jun 27, 2016

Organization subpart

No

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

Authorized official

Name

Nicholas James Paulk, MDNPI 1467604298

Title

President

Phone

(801) 268-3800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Practitioners 2

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

• Nicholas J Paulk, MD

  • Surgery Physician
  • Salt Lake City, UT
  • NPI 1467604298
  Medicare reassignment NPD Authorized official
• Steven Charles Simper, MD

  • Vascular Surgery Physician
  • Salt Lake City, UT
  • NPI 1174617336
  NPD

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1962853432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 E 3900 S STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241550",
            "telephone_number": "801-268-3800",
            "fax_number": "801-268-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 E 3900 S STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241550",
            "telephone_number": "801-268-3800",
            "fax_number": "801-268-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS J. PAULK MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-27",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "PAULK",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-268-3800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "UT",
            "license": "7872137-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edgar Ngwaru
• Henry Albert Nibley
• Nic - Salt Lake City, PLLC
• Sarah Tommi Nicely, MA
• Jonathan Robert Nichol, DO
• Grace Nicholas, MD
• Peter Michael Nicholas, LCSW
• Marilyn Nicholes
• Alvin Kirk Nichols, CRNA
• Alvin Lamar Nichols

• Surgery Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.