HEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH LLC NPI 1508518085

NPI Information

NPI: 1508518085
Provider Name: HEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH LLC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
4544 S HOLLADAY BLVD
HOLLADAY, UT
ZIP 84117
Phone: (801) 682-6817
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HEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH LLC is a multi-specialty clinic center in Holladay, UT. HEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH LLC NPI is 1508518085. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4544 S HOLLADAY BLVD
HOLLADAY, UT
ZIP 84117-404
Phone: (801) 682-6817
Fax: (385) 213-0356

The provider's authorized official is Ann Smith .
The authorized official title is Authorized Official and has the following contact phone number (801) 682-6817.

The enumeration date for this NPI number is 1/25/2022 and was last updated on 9/15/2023.

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	Primary
1	103TC1900X	Psychologist	Counseling	No
2	1041C0700X	Social Worker	Clinical	No
3	133V00000X	Dietitian, Registered		No
4	207P00000X	Emergency Medicine		No
5	207Q00000X	Family Medicine		No
6	207R00000X	Internal Medicine		No
7	207SG0201X	Medical Genetics	Clinical Genetics (M.D.)	No
8	207V00000X	Obstetrics & Gynecology		No
9	208000000X	Pediatrics		No
10	225100000X	Physical Therapist		No
11	251B00000X	Case Management		No
12	261QC1800X	Clinic/Center	Corporate Health	No
13	363A00000X	Physician Assistant		No
14	363L00000X	Nurse Practitioner		No
15	261QM1300X	Clinic/Center	Multi-Specialty	Yes

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: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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