PHYSICIAN GROUP OF UTAH INC (NPI# 1154883668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154883668 |
| Entity Type | Organization |
| Organization Name | PHYSICIAN GROUP OF UTAH INC |
| Practice Address |
5979 S 300 E Murray UT 84107-7364 |
| Mailing Address |
Po Box 281415 Atlanta GA 30384-1415 |
| Practice Telephone | 8012632370 |
| Practice Fax Number | 8012651200 |
| Mailing Telephone | 8006731270 |
| Mailing Fax Number | 3144329683 |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2019-04-03 |
| Authorized Official Name | TYLER K WILKO (CEO) |
| Authorized Official Telephone | 8019843293 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| STEWARD MEDICAL GROUP OF UTAH | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982223848 | Physician Group of Utah Inc | Internal Medicine | 1577 Dewar Dr Ste 8, Rock Springs, WY 82901-5716 | 2020-04-10 |
| 1477676930 | Physician Group of Utah Inc | Specialist | 406 W South Jordan Pkwy, Suite 500, South Jordan, UT 84095-3965 | 2007-04-09 |
| 1033671540 | Physician Group of Utah Inc | Obstetrics & Gynecology | 1580 W Antelope Dr Ste 290, Layton, UT 84041-1179 | 2019-04-03 |
| 1760944243 | Physician Group of Utah Inc | Specialist | 406 W South Jordan Pkwy Ste 500, South Jordan, UT 84095-3945 | 2019-04-03 |
| Street Address |
5979 S 300 E |
| City | MURRAY |
| State | UT |
| Zip Code | 84107-7364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326226671 | Deborah Budge | Internal Medicine | 5121 So. Cottonwood Drive, J.l. Sorenson Heart & Lung Center, Lower Level One, Murray, UT 84107-5701 | 2008-02-07 |
| 1811093453 | Utah Heart Clinic. Lc | Internal Medicine | 5169 S Cottonwood, Building B Suite 510, Murray, UT 84107-5701 | 2006-09-14 |
| 1548280464 | Yunus Ali Moosa | Internal Medicine | 300 S 8th St Ste 182w, Murray, KY 42071-2444 | 2006-07-21 |
| 1902843931 | James Langley Orford | Internal Medicine | 5169 S Cottonwood St Ste 520, Murray, UT 84107-6756 | 2006-05-31 |
| 1942208517 | Ralph D Millsaps | Internal Medicine | 1000 S 12th St, Murray, KY 42071-9303 | 2005-07-08 |
| 1376971663 | Ihc Health Services Inc | Internal Medicine | 5169 S Cottonwood St, Ste 600, Murray, UT 84107-6771 | 2013-10-23 |
| 1669773461 | Ihc Health Services Inc | Internal Medicine | 5169 Cottonwood St, Ste 510, Murray, UT 84107-6767 | 2010-11-10 |
| 1982833398 | Ihc Health Services Inc | Internal Medicine | 5169 Cottonwood St, Ste 520, Murray, UT 84107-5701 | 2009-07-07 |
| 1770742140 | Michael D. Mcculloch | Internal Medicine | 5121 S Cottonwood St, Murray, UT 84107-5701 | 2008-06-02 |
| 1467656264 | Rasheel Chowdhary | Internal Medicine | 5979 S Fashion Blvd, Murray, UT 84107-7364 | 2007-06-14 |
| Find all providers in MURRAY | ||||
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| 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.