INTEGRATED FUNCTIONAL MEDICINE NPI 1396682258

NPI Information

  • NPI: 1396682258
  • Provider Name: INTEGRATED FUNCTIONAL MEDICINE
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • Address: 4624 S HOLLADAY BLVD STE 202
    SALT LAKE CITY, UT
    ZIP 84117
  • Phone: (385) 800-5015

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NPI Details

INTEGRATED FUNCTIONAL MEDICINE is a general practice in Salt Lake City, UT. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee INTEGRATED FUNCTIONAL MEDICINE NPI is 1396682258. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4624 S HOLLADAY BLVD STE 202
SALT LAKE CITY, UT
ZIP 84117-168
Phone: (385) 800-5015
Fax: (801) 277-6678

The provider's authorized official is Scott Frogley .
The authorized official title is Owner and has the following contact phone number (801) 816-0332.

The enumeration date for this NPI number is 4/30/2026 and was last updated on 4/30/2026.

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
12085R0204XRadiologyVascular & Interventional RadiologyNo
2208D00000XGeneral PracticeYes

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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