INTERMOUNTAIN EAR,NOSE, AND THROAT SPECIALISTS LLC
NPI 1487764411
Clinic/Center - Medical Specialty in Salt Lake City, UT
NPI Status: Active since August 31, 2006
Contact Information
22 S 900 E
SALT LAKE CITY, UT
ZIP 84102
Phone: (801) 328-2522
Fax: (801) 924-2900
- Organization
- Clinic/Center
- Medical Specialty
- Accepts Insurance
- CLIA Number: 46D2043484
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-02-2026
About INTERMOUNTAIN EAR,NOSE, AND THROAT SPECIALISTS LLC
This page provides the complete NPI Profile along with additional information for Intermountain Ear,nose, And Throat Specialists Llc, a provider established in Salt Lake City, Utah operating as a Clinic/center, focusing in medical specialty . The healthcare provider is registered in the NPI registry with number 1487764411 assigned on August 2006. The practitioner's primary taxonomy code is 261QM2500X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's former legal business name is Ear,nose And Throat Center Of Salt Lake City. The authorized official of this NPI record is Evon Pefaur Cpc (Billing Manager)
- NPI
- 1487764411
- Provider Legal Name
- INTERMOUNTAIN EAR,NOSE, AND THROAT SPECIALISTS LLC
- Other Organization Name
- EAR,NOSE AND THROAT CENTER OF SALT LAKE CITY
- Other Name Type
- Former Legal Business Name (4)
- Entity Type
- Organization
- Location Address
- 22 S 900 E SALT LAKE CITY, UT 84102
- Location Phone
- (801) 328-2522
- Location Fax
- (801) 924-2900
- Mailing Address
- 22 S 900 E SALT LAKE CITY, UT 84102
- Mailing Phone
- (801) 328-2522
- Mailing Fax
- (801) 924-2900
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-31-2006
- Last Update Date
- 04-20-2008
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Medical Specialty
- Taxonomy Code
- 261QM2500X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BridgeSpan Standard Bronze Plan - HMO
- BridgeSpan Standard Gold Plan - HMO
- BridgeSpan Standard Silver Plan - HMO
- Molina Gold Core 1640 - HMO
- Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
- Molina Gold Standard - HMO
- Molina Silver Core - HMO
- Molina Silver Core Plus with Adult Dental and Vision - HMO
- Molina Silver Core Plus with Adult Vision - HMO
- Molina Silver Saver with Four Free PCP Visits - HMO
- Molina Silver Standard - HMO
- Bronze 8000 - EPO
- Bronze Essential 9000 Deductible With 4 Copay No Deductible Office Visits - EPO
- Bronze HSA 7000 - EPO
- Gold 2300 - EPO
- Regence Standard Bronze 7500 - EPO
- Regence Standard Gold 2000 - EPO
- Regence Standard Silver 6000 - EPO
- Silver 6500 - EPO
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay Office Visits - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay Office Visits - EPO
- Healthy Premier Silver Standard - EPO
- U Health Plus Bronze - EPO
- U Health Plus Expanded Bronze Standard - EPO
- U Health Plus Gold - EPO
- U Health Plus Gold Standard - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| ========= | MEDICAID (05) | UT |
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 this NPI number is:
- CLIA Number
- 46D2043484
- Facility Type
- Physician Office
- Certificate Effective Date
- July 03, 2024
- Certificate Expiration Date
- July 02, 2026
- Laboratory Director
- MELISSA MATHENS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Intermountain Ear,nose, And Throat Specialists 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.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1487764411, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 19 providers are registered at the same or a nearby location.
SALT LAKE CITY, UT 84102
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1487764411, enumerated as an "organization" on August 31, 2006.
The provider is located at 22 S 900 E SALT LAKE CITY, UT 84102 and the phone number is (801) 328-2522.
Clinic/Center with taxonomy code 261QM2500X and a focus in Medical Specialty.
The provider might be accepting Accepts: BridgeSpan Health Company, Molina Healthcare,. Please consult your insurance carrier or call the provider to verify.
