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HEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH
NPI 1508518085
Clinic/Center - Multi-Specialty in Holladay, UT

Active since January 25, 2022
4544 S HOLLADAY BLVD, HOLLADAY, UT 84117(801) 682-6817(385) 213-0356 Get Directions Write a Review

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

Record update history: Mar 6, 2026, Feb 1, 2022, Jan 25, 2022 (3 updates tracked since 2022).

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Secondary Taxonomies
  4. Group Taxonomy
  5. Authorized Official
  6. Other Providers Same Location
  7. Frequently Asked Questions
  • Organization
  • Clinic/Center
  • Multi-Specialty

About HEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH

This page provides the complete NPI Profile along with additional information for Health Diversified - Medical Group Of Utah, a provider established in Holladay, Utah operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1508518085 assigned on January 2022. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated March 2026. Health Diversified - Medical Group Of Utah operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mrs. Ann Smith (Authorized Official)

NPI
1508518085 Verify this NPI
Provider Name
HEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH
Entity Type
Organization
Location Address
4544 S HOLLADAY BLVD HOLLADAY, UT 84117
Location Phone
(801) 682-6817
Location Fax
(385) 213-0356
Mailing Address
5986 S TOLCATE WOODS LN HOLLADAY, UT 84121
Mailing Phone
(801) 682-6817
Mailing Fax
(385) 213-0356
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-25-2022
Last Update Date
03-06-2026
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 Multi-Specialty

Taxonomy Code
261QM1300X
Type
Ambulatory Health Care Facilities

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization		 License No. (State)
1103TC1900XBehavioral Health & Social Service Providers

Psychologist
Counseling

 
21041C0700XBehavioral Health & Social Service Providers

Social Worker
Clinical

 
3133V00000XDietary & Nutritional Service Providers

Dietitian, Registered

 
4207P00000XAllopathic & Osteopathic Physicians

Emergency Medicine

 
5207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

 
6207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

 
7207SG0201XAllopathic & Osteopathic Physicians

Medical Genetics
Clinical Genetics (M.D.)

 
8207V00000XAllopathic & Osteopathic Physicians

Obstetrics & Gynecology

 
9208000000XAllopathic & Osteopathic Physicians

Pediatrics

 
10225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Physical Therapist

 
11251B00000XAgencies

Case Management

 
12261QC1800XAmbulatory Health Care Facilities

Clinic/Center
Corporate Health

 
13363A00000XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant

 
14363L00000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner

 

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. ANN SMITH

Authorized Official Title
AUTHORIZED OFFICIAL
Authorized Official Phone
(801) 682-6817

Reviews for HEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

DR. DOUGLAS ROLAND SMITH M.D.
Family Medicine
4544 S HOLLADAY BLVD
HOLLADAY, UT 84117
Salt Lake County (801) 682-6817

Frequently Asked Questions

What is HEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH's NPI number?

The NPI number assigned to this healthcare provider is 1508518085, enumerated as an "organization" on January 25, 2022.

Where is the provider located?

The provider is located at 4544 S HOLLADAY BLVD HOLLADAY, UT 84117 and the phone number is (801) 682-6817.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.