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

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NPI Details

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other 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: 11/21/2025

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