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MOUNTAINSTAR OGDEN PEDIATRICS LLC NPI 1265694509


NPI Information

NPI: 1265694509
Provider Name: MOUNTAINSTAR OGDEN PEDIATRICS LLC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 46D0525121

Address:
5495 S 500 E
SUITE 120
OGDEN, UT
ZIP 84405
Phone: (801) 479-0174
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MOUNTAINSTAR OGDEN PEDIATRICS LLC is a pediatrics in Ogden, 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. MOUNTAINSTAR OGDEN PEDIATRICS LLC NPI is 1265694509. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5495 S 500 E
SUITE 120
OGDEN, UT
ZIP 84405-923
Phone: (801) 479-0174
Fax: (801) 479-8888

The provider's authorized official is Louis Joseph .
The authorized official title is Vp and has the following contact phone number (615) 373-7630.

The CLIA number assigned to this NPI record is 46D0525121 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/27/2008 and was last updated on 8/29/2023.


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
11265694509MEDICAIDUTAH

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

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