UTAH PODIATRY GROUP PC (NPI# 1700384930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700384930 |
| Entity Type | Organization |
| Organization Name | UTAH PODIATRY GROUP PC |
| Practice Address |
82 S 1100 E Ste 301 Salt Lake City UT 84102 |
| Mailing Address |
Po Box 540610 N Salt Lake UT 84054-0610 |
| Practice Telephone | 8015055277 |
| Practice Fax Number | 8015055280 |
| Mailing Telephone | 8015050821 |
| Mailing Fax Number | 8015050803 |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2019-09-03 |
| Authorized Official Name | SCOTT A CLARK (DPM) |
| Authorized Official Telephone | 8015055277 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
106339-0501 | UT | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | LICENSE | 106339-0501 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6112 S 1550 E Ste 201, South Ogden, UT 844055010 | 8014797505 | 8014751855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700369014 | Utah Podiatry Group PC | Podiatrist | 6321 S Redwood Rd Ste 102, Taylorsville, UT 84123-6799 | 2018-09-12 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1972875524 | Utah Podiatry Group PC | Podiatrist | 2159 S 700 E Ste 150, Salt Lake City, UT 84106 | 2012-01-29 |
| 1659991438 | Utah Podiatry Group PC | Podiatrist | 3435 E Pony Express Pkwy Ste 140, Eagle Mountain, UT 84005-5548 | 2020-04-21 |
| 1942733415 | Utah Podiatry Group PC | Podiatrist | 345 W 600 S, Ste 408, Heber City, UT 84032-2247 | 2017-04-11 |
| 1598205494 | Utah Podiatry Group PC | Podiatrist | 440 Medical Dr, Ste 1, Bountiful, UT 84010-4950 | 2017-02-27 |
| 1831575760 | Utah Podiatry Group PC | Podiatrist | 48 W 1500 N, Nephi, UT 84648-8900 | 2015-08-03 |
| 1457737579 | Utah Podiatry Group PC | Podiatrist | 1973 North State Street, Provo, UT 84604-1012 | 2015-07-31 |
| 1023404514 | Utah Podiatry Group PC | Podiatrist | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2015-04-10 |
| 1093081101 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E, Suite 301, Salt Lake City, UT 84102 | 2012-03-23 |
| Street Address |
82 S 1100 E STE 301 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1093359960 | Hayle Mayer | Behavior Technician | 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 | 2019-11-04 |
| 1326680869 | Ronald Mcdonald House of The Intermountain Area | Meals | 935 E. South Temple, Salt Lake City, UT 84102 | 2019-10-16 |
| 1508419581 | Claire Pemberton | Behavior Technician | 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 | 2019-07-19 |
| 1558923144 | Olivia Anne Hardwick | Social Worker | Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 | 2019-07-03 |
| 1649741802 | Colten Vancampen | Behavior Technician | 515 S 700 E #2a, Salt Lake City, UT 84102 | 2018-12-16 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1104311661 | Malorey Kooyman | Behavior Technician | 515 700 East, Suite 2a, Salt Lake City, UT 84102 | 2018-06-27 |
| 1558800045 | Benjamin Cassidy | Specialist/Technologist | 350 S 600 E, #114, Salt Lake City, UT 84102 | 2017-02-16 |
| Find all providers in zip 84102 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1972875524 | Utah Podiatry Group PC | Podiatrist | 2159 S 700 E Ste 150, Salt Lake City, UT 84106 | 2012-01-29 |
| 1891082830 | Selina Sekulic | Podiatrist | 348 E 4500 S Ste 370, Salt Lake City, UT 84107-3906 | 2011-06-28 |
| 1841586096 | Brian B Liljenquist | Podiatrist | 1250 E 3900 S Ste 440, Salt Lake City, UT 84124 | 2011-06-27 |
| 1659683381 | Christiaan Horst Goebel | Podiatrist | 4578 S Highland Dr, Suite 380, Salt Lake City, UT 84117-4243 | 2010-07-10 |
| 1639306889 | Daniel L Preece | Podiatrist | 430 N 400 W, Salt Lake City, UT 84103-1229 | 2009-06-15 |
| 1962513820 | Jason Ross Bowen | Podiatrist | 3710 Twinbrook St, Salt Lake City, UT 84109-3714 | 2006-08-31 |
| 1760499180 | Paul Norman Daniels | Podiatrist | 1449 E 3300 S, Salt Lake City, UT 84106-3308 | 2006-08-01 |
| 1710955745 | Flegal Foot & Ankle Clinic, LLC | Podiatrist | 740 E 3900 S, Suite 108, Salt Lake City, UT 84107-2525 | 2006-03-08 |
| 1700865748 | Scott A Clark | Podiatrist | 24 S 1100 E Ste 210, Salt Lake City, UT 84102 | 2006-01-10 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84102 |
Please comment or provide details below to improve the information on UTAH PODIATRY GROUP PC.
| 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.