OGDEN INTERNAL MEDICINE & UROLOGY LLC NPI 1003001553
Internal Medicine in Ogden, UT
About OGDEN INTERNAL MEDICINE & UROLOGY LLC
Ogden Internal Medicine & Urology Llc is a provider established in Ogden, Utah specializing in internal medicine. The NPI number of Ogden Internal Medicine & Urology Llc is 1003001553 and was assigned on September 2007. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 11 years ago. Ogden Internal Medicine & Urology Llc 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 Mr. David J Kane (Vice President)
The CLIA number of Ogden Internal Medicine & Urology Llc is 46D2012567 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Ogden Internal Medicine & Urology Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
| NPI | 1003001553 |
| Provider Name | OGDEN INTERNAL MEDICINE & UROLOGY LLC |
| Provider Location Address | 5405 S 500 E SUITE 100 OGDEN, UT 84405 |
| Provider Mailing Address | 5405 S 500 E SUITE 100 OGDEN, UT 84405 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | No |
| Enumeration Date | 09-07-2007 |
| Last Update Date | 10-15-2009 |
Primary Taxonomy
| Taxonomy Code | 207R00000X |
| Classification | Internal Medicine |
| Type | Allopathic & Osteopathic Physicians |
| Taxonomy Description | A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
Business Address
OGDEN INTERNAL MEDICINE & UROLOGY LLC
5405 S 500 E
SUITE 100
OGDEN, UT
ZIP 84405
Phone: (801) 475-8600
Fax: (801) 475-8686
Mailing Address
OGDEN INTERNAL MEDICINE & UROLOGY LLC
5405 S 500 E
SUITE 100
OGDEN, UT
ZIP 84405
Phone: (801) 475-8600
Fax: (801) 475-8686
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003001553 is:
| CLIA Number | 46D2012567 |
| Facility Type | PHYSICIAN OFFICE |
| Certificate Type | Certificate of Waiver |
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.
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 208800000X | Allopathic & Osteopathic Physicians | Urology | No | |||
Taxonomy Description: a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. | |||||||
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State |
|---|---|---|
| DH0022 | MEDICARE PIN (08) | |
| ========= | OTHER (01) | UT |
| 1003001553 | MEDICAID (05) | UT |
| 000062465 | MEDICARE PIN (08) | UT |
Other Providers at the same location
The following 17 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1013121003 | ALPINE PLASTIC AND RECONSTRUCTIVE SURGERY, LLC Organization | Specialist | 5405 S 500 E SUITE101 OGDEN, UT 84405 (801) 689-3500 |
| 1023003142 | GREGORY T ALMONY MD Individual | Internal Medicine (Cardiovascular Disease) | 5405 S 500 E SUITE #204 OGDEN, UT 84405 (801) 479-0194 |
| 1164425294 | DR. FAWAD TANVIR MD Individual | Internal Medicine (Infectious Disease) | 5405 S 500 E STE 100 OGDEN, UT 84405 (801) 475-8600 |
| 1265427371 | MICHAEL J DIEHL MD Individual | Internal Medicine (Interventional Cardiology) | 5405 S 500 E SUITE #204 OGDEN, UT 84405 (801) 479-0184 |
| 1356588008 | MOUNTAINSTAR MEDICAL GROUP-OGDEN REGIONAL MEDICAL CENTER, LLC Organization | Internal Medicine | 5405 S 500 E STE. 100 OGDEN, UT 84405 (801) 282-5952 |
| 1437267192 | KATHLEEN R DEREMER MD Individual | Hospitalist | 5405 S 500 E SUITE 100 OGDEN, UT 84405 (801) 475-8600 |
| 1649278581 | ALPINE SURGICAL CENTER, LLC Organization | Clinic/Center (Ambulatory Surgical) | 5405 S 500 E SUITE101 OGDEN, UT 84405 (801) 689-3500 |
| 1669666509 | UTAH HEMATOLOGY ONCOLOGY Organization | Specialist | 5405 S 500 E SUITE 202 OGDEN, UT 84405 (801) 476-1777 |
| 1699760397 | MICHAEL E CRAWFORD MD Individual | Internal Medicine (Interventional Cardiology) | 5405 S 500 E SUITE #204 OGDEN, UT 84405 (801) 479-0184 |
| 1700883600 | DR. RANDALL DEAN BARNETT M.D. Individual | Legal Medicine | 5405 S 500 E SUITE 101 OGDEN, UT 84405 (801) 689-3500 |
| 1750314480 | ROBERT R MOHR MD Individual | Internal Medicine | 5405 S 500 E STE. 100 OGDEN, UT 84405 (801) 282-5952 |
| 1760650527 | COLUMBIA OGDEN REGIONAL Organization | Family Medicine (Geriatric Medicine) | 5405 S 500 E SUITE 110 OGDEN, UT 84405 (801) 475-4379 |
| 1780846881 | DR. JULIA G ANSARI M.D. Individual | Internal Medicine (Cardiovascular Disease) | 5405 S 500 E #204 OGDEN, UT 84405 (801) 479-0184 |
| 1821274655 | NADYA P. WAYMENT M.D. Individual | Family Medicine | 5405 S 500 E STE. 100 OGDEN, UT 84405 (801) 475-7966 |
| 1922067651 | ROBERT F ZINK MD Individual | Internal Medicine (Cardiovascular Disease) | 5405 S 500 E OGDEN, UT 84405 |
| 1952326357 | ADAM C CRANER APRN Individual | Nurse Practitioner (Family) | 5405 S 500 E STE. 100 OGDEN, UT 84405 (801) 475-7966 |
| 1982844098 | DR. PETER GEORGE FORSTALL M.D. Individual | Internal Medicine (Clinical Cardiac Electrophysiology) | 5405 S 500 E SUITE 204 OGDEN, UT 84405 (801) 476-0184 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.