OGDEN INTERNAL MEDICINE & UROLOGY LLC NPI 1003001553

Internal Medicine in Ogden, UT

Organization Internal Medicine CLIA Number 46D2012567 CLIA Certificate of Waiver

About OGDEN INTERNAL MEDICINE & UROLOGY LLC

Ogden Internal Medicine & Urology Llc is an internal medicine 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 October 2020. 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 William Tedrick Johnson (Group Vp/ao)

An internist like Ogden Internal Medicine & Urology Llc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

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 NameOGDEN INTERNAL MEDICINE & UROLOGY LLC
Provider Location Address5405 S 500 E SUITE 100 OGDEN, UT 84405
Provider Mailing Address2000 HEALTH PARK DR BRENTWOOD, TN 37027
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date09-07-2007
Last Update Date10-30-2020

Primary Taxonomy

Taxonomy Code207R00000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
Taxonomy DescriptionA 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

Get Directions

Mailing Address

OGDEN INTERNAL MEDICINE & UROLOGY LLC
2000 HEALTH PARK DR
BRENTWOOD, TN
ZIP 37027
Phone: (615) 373-7600
Fax: (866) 346-1426

Authorized Official

Authorized Official Name WILLIAM TEDRICK JOHNSON
Authorized Official TitleGROUP VP/AO
Authorized Official Phone(615) 372-3375

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 Number46D2012567
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate 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
1208800000XAllopathic & Osteopathic PhysiciansUrologyNo

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
1003001553MEDICAID (05)UT

Other Providers at the same location


The following 16 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1013121003ALPINE PLASTIC AND RECONSTRUCTIVE SURGERY, LLC
Organization
Specialist5405 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
1164425294DR. 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
1356588008MOUNTAINSTAR MEDICAL GROUP-OGDEN REGIONAL MEDICAL CENTER, LLC
Organization
Internal Medicine5405 S 500 E STE. 100
OGDEN, UT 84405
(801) 282-5952
1437267192 KATHLEEN R DEREMER MD
Individual
Hospitalist5405 S 500 E SUITE 100
OGDEN, UT 84405
(801) 475-8600
1649278581ALPINE SURGICAL CENTER, LLC
Organization
Clinic/Center (Ambulatory Surgical)5405 S 500 E SUITE101
OGDEN, UT 84405
(801) 689-3500
1669666509UTAH HEMATOLOGY ONCOLOGY
Organization
Specialist5405 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
1700883600DR. RANDALL DEAN BARNETT M.D.
Individual
Legal Medicine5405 S 500 E SUITE 101
OGDEN, UT 84405
(801) 689-3500
1750314480 ROBERT R MOHR MD
Individual
Internal Medicine5405 S 500 E STE. 100
OGDEN, UT 84405
(801) 282-5952
1760650527COLUMBIA OGDEN REGIONAL
Organization
Family Medicine (Geriatric Medicine)5405 S 500 E SUITE 110
OGDEN, UT 84405
(801) 475-4379
1821274655 NADYA P. WAYMENT M.D.
Individual
Family Medicine5405 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
1982844098DR. 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.