Provider Type Icon

UNIVERSITY OF UTAH GENERAL PEDIATRICS NPI 1023051166


NPI Information

NPI: 1023051166
Provider Name: UNIVERSITY OF UTAH GENERAL PEDIATRICS
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 46D2211247

Address:
100 N MEDICAL DR
SALT LAKE CITY, UT
ZIP 84113
Phone: (801) 588-2233
Get Directions

UNIVERSITY OF UTAH GENERAL PEDIATRICS is a pediatrics in Salt Lake City, UT. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. UNIVERSITY OF UTAH GENERAL PEDIATRICS NPI is 1023051166. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

100 N MEDICAL DR
SALT LAKE CITY, UT
ZIP 84113-103
Phone: (801) 588-2233
Fax: (801) 588-2236

The provider's authorized official is Edward B Clark .
The authorized official title is Chair and has the following contact phone number (801) 587-7400.

The CLIA number assigned to this NPI record is 46D2211247 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/14/2006 and was last updated on 9/6/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1122032200MEDICAIDWYOMING
247157844MEDICAIDCOLORADO
37116627MEDICAIDWASHINGTON
4=========000MEDICAIDUTAH
5000055821MEDICARE ID-TYPE UNSPECIFIEDUTAH
6805687000MEDICAIDIDAHO
7100501970MEDICAIDNEVADA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.