NPI Code Detail JSON Logo

1548304025 NPI number — RICHARD O CLUFF CRNA

NPI Number: 1548304025
Health Care Provider/Practitioner: RICHARD O CLUFF CRNA

Information about “1548304025” NPI (RICHARD O CLUFF CRNA) exists in 1548304025 in HTML format HTML  |  1548304025 in plain Text format TXT  |  1548304025 in PDF (Portable Document Format) PDF  |  1548304025 in an XML format XML  formats.

NPI Number : 1548304025 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1548304025",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CLUFF",
    "FirstName": "RICHARD",
    "MiddleName": "O",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "CRNA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1954 FORT UNION BLVD",
    "SecondLineMailingAddress": "SUITE 101",
    "MailingAddressCityName": "SALT LAKE CITY",
    "MailingAddressStateName": "UT",
    "MailingAddressPostalCode": "84121-6800",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "801-993-9581",
    "MailingAddressFaxNumber": "801-733-5618",
    "FirstLinePracticeLocationAddress": "750 W 800 N",
    "SecondLinePracticeLocationAddress": "ANESTHESIA DEPT",
    "PracticeLocationAddressCityName": "OREM",
    "PracticeLocationAddressStateName": "UT",
    "PracticeLocationAddressPostalCode": "84057-3660",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "801-714-6000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/16/2007",
    "LastUpdateDate": "06/30/2009",
    "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": "367500000X",
          "TaxonomyName": "Certified Registered Nurse Anesthetist",
          "LicenseNumber": "264714-4406",
          "LicenseNumberStateCode": "UT",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "367500000X",
          "TaxonomyName": "Certified Registered Nurse Anesthetist",
          "LicenseNumber": "RNA-677",
          "LicenseNumberStateCode": "ID",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.