UNIVERSITY OF UTAH COMMUNITY PHYSICIANS GROUP (NPI# 1124422126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124422126 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF UTAH COMMUNITY PHYSICIANS GROUP |
| Practice Address |
1525 W 2100 S Salt Lake City UT 84119-1401 |
| Mailing Address |
Po Box 841450 Los Angeles CA 90084-1450 |
| Practice Telephone | 8015876336 |
| Mailing Telephone | 8015876336 |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2020-05-20 |
| Authorized Official Name | EDWARD CLARK (DEPT. CHAIR) |
| Authorized Official Telephone | 8015876336 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699179267 | University of Utah Community Physicians Group | Family Medicine | 26 S Main St, Centerville, UT 84014-1817 | 2014-10-10 |
| 1780088351 | University of Utah Community Physicians Group | Family Medicine | 5126 W Daybreak Pkwy, Ste 600, South Jordan, UT 84095-5994 | 2014-10-10 |
| 1528462231 | University of Utah Community Physicians Group | Family Medicine | 7495 S State St, Midvale, UT 84047-2013 | 2014-10-09 |
| 1356745061 | University of Utah Community Physicians Group | Family Medicine | 1492 W Antelope Dr Ste 150, Layton, UT 84041-1137 | 2014-10-09 |
| 1598169203 | University of Utah Community Physicians Group | Family Medicine | 1525 W 2100 S, Salt Lake City, UT 84119-1401 | 2014-10-09 |
| 1497159107 | University of Utah Community Physicians Group | Family Medicine | 220 Millpond Ste 100, Stansbury Pk, UT 84074-9760 | 2014-10-09 |
| 1912301615 | University of Utah Community Physicians Group | Family Medicine | 555 Foothill Dr, Ste 600, Salt Lake City, UT 84112-1106 | 2014-10-09 |
| 1730583444 | University of Utah Community Physicians Group | Family Medicine | 1138 E Wilmington Ave, Salt Lake City, UT 84106-2819 | 2014-10-09 |
| 1427452135 | University of Utah Community Physicians Group | Family Medicine | 145 W University Pkwy, Orem, UT 84058-7316 | 2014-10-09 |
| 1932503646 | University of Utah Community Physicians Group | Family Medicine | 3730 W 4700 S, Taylorsville, UT 84129-3457 | 2014-10-09 |
| Street Address |
1525 W 2100 S |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84119-1401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285624197 | Leslie Anne Gregersen | Pharmacist | 1525 W 2100 S, Salt Lake City, UT 84119-1401 | 2005-10-24 |
| 1174184758 | Cara Wolf | Nurse Practitioner | 1525 W 2100 S, Salt Lake City, UT 84119-1407 | 2019-06-25 |
| 1891272845 | Megan Whitlock | Social Worker | 1525 W 2100 S, Salt Lake City, UT 84119-1407 | 2018-07-23 |
| 1942718473 | Kristi Leavitt Nichols | Midwife | 1525 W 2100 S, Salt Lake City, UT 84119-1407 | 2018-01-18 |
| 1639697931 | Gilbert Gaertner IIi | Physician Assistant | 1525 W 2100 S, Salt Lake City, UT 84119-1407 | 2017-09-07 |
| 1528589579 | Rebecca Kline Burt | Family Medicine | 1525 W 2100 S, Salt Lake City, UT 84119-1407 | 2017-06-29 |
| 1861932576 | Brooke Diane Mariger Paulsen | Nurse Practitioner | 1525 W 2100 S, Salt Lake City, UT 84119-1407 | 2017-02-28 |
| 1356889703 | Ghaida Al-barzinji | Physician Assistant | 1525 W 2100 S, Salt Lake City, UT 84119-1407 | 2017-02-06 |
| 1184077075 | Bobbi Heaney | Nurse Practitioner | 1525 W 2100 S, Salt Lake City, UT 84119-1407 | 2016-07-15 |
| 1700234655 | Caroline Berry Carlson | Physician Assistant | 1525 W 2100 S, Salt Lake City, UT 84119-1407 | 2016-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164981932 | Arches Home Care, Inc. | Non-emergency Medical Transport (VAN) | 1385 W 2200 S Ste 203, West Valley City, UT 84119 | 2019-03-19 |
| 1629591003 | Exemplar Healthcare, Inc. | Hospice Care, Community Based | 1385 W 2200 S Ste 202, West Valley City, UT 84119 | 2017-07-18 |
| 1619358496 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 2875 S Decker Lake Dr Ste 180, West Valley City, UT 84119 | 2015-06-17 |
| 1821407735 | Nathan William Stobbe | Dentist | 3280 W. 3500 S. Ste 3, West Valley, UT 84119 | 2014-08-05 |
| 1801209028 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3148 W 3500 S, West Valley City, UT 84119 | 2014-06-05 |
| 1215347935 | Karl Edward Jennings | Social Worker | 3901 S David Pl, West Valley City, UT 84119 | 2014-05-02 |
| 1750624672 | Shannon Quinn Dunlop | Registered Nurse | 2621 S 3270 W, West Valley City, UT 84119 | 2013-03-28 |
| 1215273529 | Holly H Tanski | Counselor | 5770 S. 1500 W. Bld A, Ihc Wasatch Canyons Campus, Salt Lake City, UT 84119 | 2012-12-14 |
| 1982955860 | Oquirrh Meadows Care and Rehab, Inc | Assisted Living Facility | 2948 So. Redwood Road, West Valley City, UT 84119 | 2012-10-02 |
| 1518235068 | Asjad Kaleem Mohammed | Pharmacist | 2290 S Redwood Road, Olive Pharmacy, Salt Lake City, UT 84119 | 2011-12-12 |
| Find all providers in zip 84119 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647480 | Utah Therapeutic Health Center | General Practice | 740 E 3900 S Ste 108, Salt Lake City, UT 84107-2525 | 2020-07-23 |
| 1750922415 | Woundtech of Utah, Inc. | General Practice | 517 D St, Salt Lake City, UT 84103-2831 | 2019-10-03 |
| 1588928923 | Douglas Stein | General Practice | 5 S 500 W Unit 1205, Salt Lake City, UT 84101-4127 | 2012-06-29 |
| 1639430960 | Rita Florian Pingree | General Practice | 350 S 200 E, 400, Salt Lake City, UT 84111-2410 | 2012-06-04 |
| 1437430915 | Carter Brooke Jennings | General Practice | 2811 E 4135 S, Salt Lake City, UT 84124-3043 | 2011-08-29 |
| 1255620068 | Chad Chenoweth | General Practice | 1512 E 3115 S, Salt Lake City, UT 84106-3456 | 2011-04-01 |
| 1154622587 | Wallace Harold Ring | General Practice | 3125 Kennedy Dr., 1003, Salt Lake City, UT 84108-2110 | 2010-11-17 |
| 1639484025 | Fast Track Billing Inc | General Practice | 50 W Broadway, Suite 1000, Salt Lake City, UT 84101-2020 | 2010-08-10 |
| 1639495047 | Martin Richard Buta | General Practice | Department of General Surgery, 30 N. 1900 E., 3b324 Som, Salt Lake City, UT 84132-0001 | 2010-04-09 |
| 1548406325 | Brent Carl James | General Practice | 36 S State St Fl 16, Salt Lake City, UT 84111-1633 | 2008-12-27 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84119 |
Please comment or provide details below to improve the information on UNIVERSITY OF UTAH COMMUNITY PHYSICIANS GROUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.