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1164434486 NPI number — SCOTT ABEREGG MD

NPI Number: 1164434486
Health Care Provider/Practitioner: SCOTT ABEREGG MD

Information about “1164434486” NPI (SCOTT ABEREGG MD) exists in 1164434486 in HTML format HTML  |  1164434486 in plain Text format TXT  |  1164434486 in PDF (Portable Document Format) PDF  |  1164434486 in an XML format XML  formats.

NPI Number : 1164434486 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164434486",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ABEREGG",
    "FirstName": "SCOTT",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "700 ACKERMAN RD",
    "SecondLineMailingAddress": "SUITE 385",
    "MailingAddressCityName": "COLUMBUS",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "43202-1559",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "614-947-3700",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5979 S FASHION BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MURRAY",
    "PracticeLocationAddressStateName": "UT",
    "PracticeLocationAddressPostalCode": "84107",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "801-265-2370",
    "PracticeLocationAddressFaxNumber": "801-265-1200",
    "EnumerationDate": "08/13/2006",
    "LastUpdateDate": "10/15/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "7265111-1205",
          "LicenseNumberStateCode": "UT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RP1001X",
          "TaxonomyName": "Pulmonary Disease Physician",
          "LicenseNumber": "7265111-1205",
          "LicenseNumberStateCode": "UT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RC0200X",
          "TaxonomyName": "Critical Care Medicine (Internal Medicine) Physician",
          "LicenseNumber": "7265111-1205",
          "LicenseNumberStateCode": "UT",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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