PHYSICIAN GROUP OF UTAH INC
NPI 1477676930
Specialist in South Jordan, UT

Active since April 09, 2007
406 W SOUTH JORDAN PKWY, SUITE 500, SOUTH JORDAN, UT 84095(801) 984-3418(801) 984-3479 Get Directions Write a Review

NPPES record last updated: March 6, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Physician Group Of Utah Inc NPPES

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

PHYSICIAN GROUP OF UTAH INC (NPI 1477676930) is a healthcare organization registered as a specialist in South Jordan, Utah and active in the NPI registry since April 2007. The organization lists Ashley Koch, Cfo, as its authorized official.

NPPES Registry Identity

NPI1477676930
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NamePHYSICIAN GROUP OF UTAH INC
Location Address406 W SOUTH JORDAN PKWY, SUITE 500South Jordan, UT 84095-3965
Mailing AddressPo Box 281415Atlanta, GA 30384-1415 · (800) 673-1270 · Fax (314) 432-9683
Fax(801) 984-3479
Organization SubpartNo
Authorized OfficialAshley KochCfo · (617) 562-7070
Enumeration DateApril 9, 2007
Last NPPES UpdateMarch 6, 2020
NPPES CertifiedMarch 6, 2020
NPI 1477676930 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.

406 W SOUTH JORDAN PKWY, South Jordan, UT 84095

Other Identifiers 1

Medicaid1477676930UT

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


The following 2 providers are registered at the same or a nearby location.

Community/Behavioral Health
406 W SOUTH JORDAN PKWY, SUITE 220B
SOUTH JORDAN, UT 84095
General Practice
406 W SOUTH JORDAN PKWY, SUITE 450
SOUTH JORDAN, UT 84095

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1477676930, enumerated as an "organization" on April 09, 2007.

The provider is located at 406 W SOUTH JORDAN PKWY SUITE 500 SOUTH JORDAN, UT 84095 and the phone number is (801) 984-3418.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.