NPIMap

Organization Active NPI

Salt Lake Specialty Hospital Inc

  • Long Term Care Hospital
  • Murray, UT
National Provider Identifier
1992548960
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
Legal business name
SALT LAKE SPECIALTY HOSPITAL INC
Practice address
4252 S Birkhill Blvd
Murray, UT 84107-5715
Phone
(385) 425-0050
NPI assigned
Jun 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Authorized official

Name
Manpreet Singh
Title
Director of Operations
Phone
(707) 503-8772

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X Primary
Pharmacy 333600000X
Institutional Pharmacy 3336I0012X

Addresses

Primary practice location

4252 S Birkhill Blvd
Murray, UT 84107-5715

Mailing address

700 17TH St Ste 205
Modesto, CA 95354-1249
Phone (707) 503-8772

Other names 1

  • Salt Lake Specialty Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240820001599 UT Part A Provider - Hospital 9931647054 Practice locations: Murray, UT

Hospital certification: CCN 462004

Legal name
SALT LAKE SPECIALTY HOSPITAL INC
Doing business as
SALT LAKE SPECIALTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Feb 1, 2003
Last certification
Aug 9, 2012
Beds
41
Ownership / control type
Private (for profit)
Organization structure
CorporationProprietary
Incorporated
May 2, 2024 in CA
Enrollment address
4252 S Birkhill Blvd
Murray, UT 84107-5715
Main/Primary Hospital Location
Hospital subgroups
General, Long-term

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Salt Lake Specialty HospitalCCN 462004
Ownership
For profit
Certified
Feb 1, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Beds
41

National Provider Directory

National Provider Directory
Tax ID family
Salt Lake Specialty Hospital Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gurpreet Singh Randhawa Individual 5% Or Greater Direct Ownership InterestChief Executive Officer May 19, 2024 100%
Operational/Managerial ControlCeo May 19, 2024 100%
Shamsher Bhullar Individual Operational/Managerial ControlSecretary May 19, 2024
Tammy Thompson Individual Corporate OfficerChief Financial Officer May 19, 2024
Salt Lake Specialty Hospital Inc Organization, Modesto, CA Created for acquisition, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 19, 2024 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Gurpreet Singh, MD
    • Gastroenterology Physician
    • Turlock, CA
    • NPI 1194780999

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1992548960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 17TH ST STE 205",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953541249",
            "telephone_number": "707-503-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4252 S BIRKHILL BLVD",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075715",
            "telephone_number": "385-425-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT LAKE SPECIALTY HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "MANPREET",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "707-503-8772"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Salt Lake Specialty Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.