PEDIATRIC ADOLESCENT MEDICINE DEPARTMENT OF UNIVERISTY OF UTAH
NPI 1639123896
Pediatrics - Adolescent Medicine in Salt Lake City, UT

NPI Status: Active since May 20, 2006

Contact Information

50 N MEDICAL DR
SALT LAKE CITY, UT
ZIP 84132
Phone: (801) 581-3501
Fax: (801) 581-4920

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  • Organization
  • Pediatrics
  • Adolescent Medicine

About PEDIATRIC ADOLESCENT MEDICINE DEPARTMENT OF UNIVERISTY OF UTAH

This page provides the complete NPI Profile along with additional information for Pediatric Adolescent Medicine Department Of Univeristy Of Utah, a pediatrician established in Salt Lake City, Utah operating as a Pediatrics, focusing in adolescent medicine . The healthcare provider is registered in the NPI registry with number 1639123896 assigned on May 2006. The practitioner's primary taxonomy code is 2080A0000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. Pediatric Adolescent Medicine Department Of Univeristy Of Utah operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Dr. Edward B Clark Md (Chair)

NPI
1639123896
Provider Name
PEDIATRIC ADOLESCENT MEDICINE DEPARTMENT OF UNIVERISTY OF UTAH
Entity Type
Organization
Location Address
50 N MEDICAL DR SALT LAKE CITY, UT 84132
Location Phone
(801) 581-3501
Location Fax
(801) 581-4920
Mailing Address
295 CHIPETA WAY PEDS ADMIN SALT LAKE CITY, UT 84108
Mailing Phone
(801) 587-7400
Mailing Fax
(801) 581-4920
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-20-2006
Last Update Date
09-06-2011
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A pediatrician like Pediatric Adolescent Medicine Department Of Univeristy Of Utah is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pediatrics Adolescent Medicine

Taxonomy Code
2080A0000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208000000XAllopathic & Osteopathic Physicians

Pediatrics

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. EDWARD B CLARK MD

Authorized Official Title
CHAIR
Authorized Official Phone
(801) 587-7400

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
807297100MEDICAID (05)ID 
=========001MEDICAID (05)UT 
121820400MEDICAID (05)WY 
000058094MEDICARE ID-TYPE UNSPECIFIED (04)UT 
100507432MEDICAID (05)NV 

Reviews for PEDIATRIC ADOLESCENT MEDICINE DEPARTMENT OF UNIVERISTY OF UTAH

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1639123896
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2669226818
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 6 + 9 + 2 + 2 + 6 + 8 + 1 + 8 + 24 = 74
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 74 = 66

The NPI number 1639123896 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1750388104MR. LONNIE DOYLE SMITH PHARMD
Individual
Pharmacist (Pharmacotherapy)50 N MEDICAL DR RM PA455
SALT LAKE CITY, UT 84132
(801) 585-2641
1053302984DR. HEATHER ANNE NYMAN PHARMD
Individual
Pharmacist50 N MEDICAL DR RM A050
SALT LAKE CITY, UT 84132
(801) 585-7649
1245219278MRS. PILAR LENGLET MAGOULAS MS, CGC
Individual
Genetic Counselor, MS50 N MEDICAL DR SOM 2C412
SALT LAKE CITY, UT 84132
(801) 581-8943
1194794693 TERESA WILLARD LCSW
Individual
Social Worker (Clinical)50 N MEDICAL DR
SALT LAKE CITY, UT 84132
(801) 585-2717
1518928621 KRISTEN M RIES MD
Individual
Internal Medicine (Infectious Disease)50 N MEDICAL DR
SALT LAKE CITY, UT 84132
(801) 585-3203
1548218233DR. SARA ROBERTSON VAZQUEZ PHARM.D
Individual
Pharmacist50 N MEDICAL DR ROOM 1R211
SALT LAKE CITY, UT 84132
(801) 585-3713
1811946619U-U HEMATOLOGY-ONCOLOGY DIVISION
Organization
Internal Medicine50 N MEDICAL DR
SALT LAKE CITY, UT 84132
(801) 581-2121
1427007228 MARGARET KER HUI YU M.D.
Individual
Internal Medicine50 N MEDICAL DR
SALT LAKE CITY, UT 84132
(801) 581-2121
1578513842 JAMES P KUSHNER M.D.
Individual
Internal Medicine50 N MEDICAL DR
SALT LAKE CITY, UT 84132
(801) 581-2121
1649220948 SCHICKWANN TSAI M.D.
Individual
Internal Medicine50 N MEDICAL DR
SALT LAKE CITY, UT 84132
(801) 581-2121
1174573323 ROBERT A DENT P.A.
Individual
Physician Assistant50 N MEDICAL DR
SALT LAKE CITY, UT 84132
(801) 581-2121
1467402628 MALINDA KAYE HORTON P.N.P.
Individual
Nurse Practitioner50 N MEDICAL DR
SALT LAKE CITY, UT 84132
(801) 581-2121
1063464360DR. CLAUDIA GOULSTON M.D.
Individual
Internal Medicine (Infectious Disease)50 N MEDICAL DR
SALT LAKE CITY, UT 84132
(801) 581-2121
1861444929 ROBERTA Y WANG MD
Individual
Obstetrics & Gynecology50 N MEDICAL DR
SLC, UT 84132
(801) 581-2719
1134172042U-U NONINVASIVE VASCULAR LAB
Organization
Surgery50 N MEDICAL DR
SALT LAKE CITY, UT 84132
(801) 581-2121
1528011327DR. WILLIAM R HOWELL M.B.B.CH.
Individual
Internal Medicine50 N MEDICAL DR
SALT LAKE CITY, UT 84132
(801) 581-2121
1871546697 JODI FOLEY DAYTON MD
Individual
Anesthesiology50 N MEDICAL DR
SLC, UT 84132
(801) 581-6393
1104870807UNIVERSITY OF UTAH OB CARE NOW
Organization
Advanced Practice Midwife50 N MEDICAL DR
SALT LAKE CITY, UT 84132
(801) 587-9500
1477507184UNIVERSITY OF UTAH HOSPITAL PROFESSIONAL SERVICES
Organization
Genetic Counselor, MS50 N MEDICAL DR
SALT LAKE CITY, UT 84132
(801) 587-9500
1629022827PEDIATRIC GENETICS DEPARTMENT OF UNIVERSITY OF UTAH
Organization
Medical Genetics (Clinical Genetics (M.D.))50 N MEDICAL DR
SALT LAKE CITY, UT 84132
(801) 581-8943

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639123896, enumerated in the NPI registry as an "organization" on May 20, 2006

The provider is located at 50 N Medical Dr Salt Lake City, Ut 84132 and the phone number is (801) 581-3501

This medical organization specializes in Pediatrics with taxonomy code 2080A0000X with a focus in Adolescent Medicine

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on May 20, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.