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CENTENNIAL MEDICAL PRACTICE PC
NPI 1174333975
Specialist in Park City, UT

Active since January 13, 2025
1743 SIDEWINDER DRIVE, #114, PARK CITY, UT 84060(307) 840-9834(833) 450-0933 Get Directions Write a Review

NPPES record last updated: January 13, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Centennial Medical Practice Pc NPPES

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

CENTENNIAL MEDICAL PRACTICE PC (NPI 1174333975) is a healthcare organization registered as a specialist in Park City, Utah and active in the NPI registry since January 2025. The organization lists Ashwin Muralidharan, President, as its authorized official.

NPPES Registry Identity

NPI1174333975
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameCENTENNIAL MEDICAL PRACTICE PC
Location Address1743 SIDEWINDER DRIVE, #114Park City, UT 84060-7322
Mailing Address1743 Sidewinder Drive, #114Park City, UT 84060-7322 · (307) 840-9834 · Fax (833) 450-0933
Phone(307) 840-9834
Fax(833) 450-0933
Organization SubpartNo
Authorized OfficialAshwin MuralidharanPresident · (307) 840-9834
Enumeration DateJanuary 13, 2025
NPPES CertifiedJanuary 10, 2025
✔ NPI 1174333975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1743 SIDEWINDER DRIVE, Park City, UT 84060
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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

Other Providers at the Same Location NPPES 3

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

KAY NEGISHI
Internal Medicine
1743 SIDEWINDER DRIVE, UNIT 114
PARK CITY, UT 84060
Summit County (307) 840-9834
BABBLMR, INC.
In Home Supportive Care
1743 SIDEWINDER DRIVE, 1ST FLOOR
PARK CITY, UT 84060
Summit County (844) 674-7774
CARE PLANNING INSTITUTE, INC
In Home Supportive Care
1743 SIDEWINDER DRIVE
PARK CITY, UT 84060
Summit County (877) 467-8166

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 Centennial Medical Practice PC's NPI number?

The NPI number for Centennial Medical Practice PC is 1174333975. It was assigned to this organization in the NPPES registry on January 13, 2025.

Where is Centennial Medical Practice PC located?

Centennial Medical Practice PC is located at 1743 Sidewinder Drive #114, Park City, UT 84060. The listed phone number is (307) 840-9834.

What is Centennial Medical Practice PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Centennial Medical Practice PC was last updated on January 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.