NPIMap

Organization Active NPI

University of Utah Adult Services

Doing business as Eastern Idaho Regional MC-Cardiology EP

  • Clinical Cardiac Electrophysiology Physician
  • Idaho Falls, ID
National Provider Identifier
1992182547
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
Legal business name
UNIVERSITY OF UTAH ADULT SERVICES
Doing business as
Eastern Idaho Regional MC-Cardiology EP
Practice address
3100 Channing Way
Ste 600
Idaho Falls, ID 83404-7533
Phone
(801) 587-6336
NPI assigned
May 4, 2015
Last updated
Jan 22, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF UTAH ADULT SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Authorized official

Name
Dr. Samuel Finlayson, MD
Title
Chief Clinical Officer
Phone
(801) 587-6336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X NU Primary

Addresses

Primary practice location

3100 Channing Way
Ste 600
Idaho Falls, ID 83404-7533

Mailing address

PO Box 841450
Los Angeles, CA 90084-1450

Other names 1

  • Eastern Idaho Regional MC-Cardiology EP Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150717001509 ID Part B Supplier - Clinic/Group Practice 0941525273 Receives reassigned benefits from 18 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Idaho Falls, ID; Pocatello, ID; Meridian, ID; Boise, ID

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Univ of Utah Adult Serv34 organizations share this tax ID, including this one
Part of
Univ of Utah Adult Serv

Other organizations with this tax ID 33

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

View all 33

Locations

3100 Channing Way
Ste 600
Idaho Falls, ID 83404

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1992182547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841450",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900841450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "address_2": "STE 600",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "801-587-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF UTAH ADULT SERVICES",
        "enumeration_date": "2015-05-04",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "FINLAYSON",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "801-587-6336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Idaho Regional MC-Cardiology EP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eastern Idaho Regional MC-Cardiology EP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.