SOUTH SUMMIT PEDIATRICS. LLC
NPI 1760490122
Legal Medicine in Draper, UT
NPI Status: Active since August 03, 2006
Contact Information
267 E TRAVERSEPOINT DRIVE
DRAPER, UT
ZIP 84020
Phone: (801) 567-9780
Fax: (801) 567-9826
- Organization
- Legal Medicine
- Accepts Insurance
- CLIA Number: 46D1073164
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-30-2026
About SOUTH SUMMIT PEDIATRICS. LLC
This page provides the complete NPI Profile along with additional information for South Summit Pediatrics. Llc, a provider established in Draper, Utah operating as a Legal Medicine. The healthcare provider is registered in the NPI registry with number 1760490122 assigned on August 2006. The practitioner's primary taxonomy code is 173000000X with license number 363788-1205 (UT). The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Paul S Lei M.d. (Owner)
- NPI
- 1760490122
- Provider Name
- SOUTH SUMMIT PEDIATRICS. LLC
- Entity Type
- Organization
- Location Address
- 267 E TRAVERSEPOINT DRIVE DRAPER, UT 84020
- Location Phone
- (801) 567-9780
- Location Fax
- (801) 567-9826
- Mailing Address
- 267 E TRAVERSEPOINT DRIVE DRAPER, UT 84020
- Mailing Phone
- (801) 567-9780
- Mailing Fax
- (801) 567-9826
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-03-2006
- Last Update Date
- 11-13-2007
- 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
Legal Medicine
- Taxonomy Code
- 173000000X
- Type
- Other Service Providers
- License No.
- 363788-1205
- License State
- UT
- Taxonomy Description
- The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
- Bronze 4 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 6 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- BridgeSpan Standard Bronze Plan - HMO
- BridgeSpan Standard Gold Plan - HMO
- BridgeSpan Standard Silver Plan - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Bronze Essential 8500 Deductible With 4 Copay No Deductible Office Visits - EPO
- Bronze HSA 7000 - EPO
- Gold 2300 - EPO
- Regence Standard Bronze 7500 - EPO
- Regence Standard Gold 1500 - EPO
- Regence Standard Silver 5000 - EPO
- SaveWell Standard Bronze 7500 - EPO
- SaveWell Standard Gold 1500 - EPO
- SaveWell Standard Silver 5000 - EPO
- Silver 5000 - EPO
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay - EPO
- Healthy Premier Silver 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 |
|---|---|---|---|
| 1760490122 | MEDICARE PIN (08) | 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
- 46D1073164
- Facility Type
- Physician Office
- Certificate Effective Date
- May 01, 2024
- Certificate Expiration Date
- April 30, 2026
- Laboratory Director
- PAUL S. LEI MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to South Summit Pediatrics. 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 Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 6 | 0 | 4 | 9 | 0 | 1 | 2 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 12 | 0 | 8 | 9 | 0 | 1 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 2 + 0 + 8 + 9 + 0 + 1 + 4 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1760490122 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760490122, enumerated in the NPI registry as an "organization" on August 03, 2006
The provider is located at 267 E Traversepoint Drive Draper, Ut 84020 and the phone number is (801) 567-9780
This medical organization specializes in Legal Medicine with taxonomy code 173000000X
The provider might be accepting Accepts: Aetna CVS Health, BridgeSpan Health Company,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 46D1073164 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued 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..
This NPI record was last updated on August 03, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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