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PEDIATRIC NEPHROLOGY DEPARTMENT OF UNIVERSITY OF UTAH
NPI 1114027968
Pediatrics - Pediatric Nephrology in Salt Lake City, UT

Active since September 22, 2006
100 N MEDICAL DR, PEDIATRIC NEPHROLOGY, SALT LAKE CITY, UT 84113(801) 588-2000(801) 587-7406 Get Directions Write a Review

NPPES record last updated: September 6, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pediatric Nephrology Department Of University Of Utah NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC NEPHROLOGY DEPARTMENT OF UNIVERSITY OF UTAH (NPI 1114027968) is a healthcare organization registered as a pediatric nephrology in Salt Lake City, Utah and active in the NPI registry since September 2006. The organization lists Edward B Clark, Dept Chair, as its authorized official.

NPPES Registry Identity

NPI1114027968
Entity TypeOrganization
Primary Taxonomy2080P0210X
Legal Business NamePEDIATRIC NEPHROLOGY DEPARTMENT OF UNIVERSITY OF UTAH
Location Address100 N MEDICAL DR, PEDIATRIC NEPHROLOGYSalt Lake City, UT 84113-1103
Mailing Address295 Chipeta Way, U Of U Som Dept Of PediatricsSalt Lake City, UT 84108-1220 · (801) 587-7400 · Fax (801) 587-7417
Phone(801) 588-2000
Fax(801) 587-7406
Organization SubpartNo
Authorized OfficialEdward B ClarkDept Chair · (801) 587-7400
Enumeration DateSeptember 22, 2006
Last NPPES UpdateSeptember 6, 2011
✔ NPI 1114027968 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0210X
Definition
A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy.
Also ListedPediatricsTaxonomy 208000000X
100 N MEDICAL DR, Salt Lake City, UT 84113
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Other Identifiers 6

Medicaid807147800ID
Medicare ID-Type Unspecified000057975UT
Medicaid807148700ID
Medicaid121250800WY
Medicaid=========001UT
Medicaid100507103NV

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LISA ANN RUNYON CPNP
Nurse Practitioner (Pediatrics)
100 N MEDICAL DR, TRAUMA SERVICES
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-2993
KATHERINE A HUGHES OT
Occupational Therapist
100 N MEDICAL DR
SLC, UT 84113
Salt Lake County (801) 588-2000
LINDA M LAMBERT A.P.R.N.
Nurse Practitioner
100 N MEDICAL DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-1000
MS. ANN A. K. KAMP APRN
Nurse Practitioner (Neonatal)
100 N MEDICAL DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-1000
UNIVERSITY OF UTAH GENERAL PEDIATRICS
Pediatrics
100 N MEDICAL DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 588-2233
DR. TYSON STUART HORKLEY M.D.
Pediatrics
100 N MEDICAL DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 267-1855
MS. DEBRA ANN TEMPLIN NP
Nurse Practitioner (Pediatrics, Critical Care)
100 N MEDICAL DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-2447
BONNIE ANN CLAY CPNP
Nurse Practitioner (Pediatrics)
100 N MEDICAL DR, 2800
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-5566

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pediatric Nephrology Department Of University Of Utah's NPI number?

The NPI number for Pediatric Nephrology Department Of University Of Utah is 1114027968. It was assigned to this organization in the NPPES registry on September 22, 2006.

Where is Pediatric Nephrology Department Of University Of Utah located?

Pediatric Nephrology Department Of University Of Utah is located at 100 N Medical Dr Pediatric Nephrology, Salt Lake City, UT 84113. The listed phone number is (801) 588-2000.

What is Pediatric Nephrology Department Of University Of Utah's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Nephrology, with taxonomy code 2080P0210X.

What insurance does Pediatric Nephrology Department Of University Of Utah accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Pediatric Nephrology Department Of University Of Utah as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pediatric Nephrology Department Of University Of Utah was last updated on September 6, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.