DR. DAVID MORTIN GONTRUM


Address: 4745 S 3200 W, Salt Lake City, UT 84118-2822
Phone: 8019646214

DR. DAVID MORTIN GONTRUM (NPI# 1922084813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922084813
Entity Type Individual
Full Name DR. DAVID MORTIN GONTRUM
Credential M.D.
Practice Address 4745 S 3200 W
Salt Lake City
UT 84118-2822
Mailing Address 1082 Lake St
Salt Lake City
UT 84105-1261
Practice Telephone 8019646214
Mailing Telephone 8015371642
Enumeration Date 2005-12-21
Last Update Date 2011-11-07
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 350320-1205 UT Allopathic & Osteopathic Physicians

Office Location

Street Address 4745 S 3200 W
City SALT LAKE CITY
State UT
Zip Code 84118-2822

Providers in the same location

NPI Name Taxonomy Address Enumeration
1174962963 Maria Dalia Garza Counselor 4745 S 3200 W, Salt Lake City, UT 84129-2822 2013-06-14
1215238530 Susanna Benavidez Chapman Physician Assistant 4745 S 3200 W, Taylorsville, Salt Lake City, UT 84118-2822 2010-11-03
1548471147 Linda Stearns Registered Nurse 4745 S 3200 W, Salt Lake City, UT 84118-2822 2007-05-24
1770600918 Thomas Carlyle Whittaker Family Medicine 4745 S 3200 W, Salt Lake City, UT 84118-2822 2007-03-23
1801992953 Community Health Centers Inc. Obstetrics & Gynecology 4745 S 3200 W, Salt Lake City, UT 84118-2822 2006-09-16
1356446215 Martha P Mandujano Physician Assistant 4745 S 3200 W, Salt Lake City, UT 84118-2822 2006-09-14
1902901838 Phung Kim Do Physician Assistant 4745 S 3200 W, Salt Lake City, UT 84118-2822 2006-09-14
1316923113 Keith Owen Horwood Family Medicine 4745 S 3200 W, Salt Lake City, UT 84118-2822 2005-12-22
1265419022 Kathy Jane Pedersen Family Medicine 4745 S 3200 W, Salt Lake City, UT 84118-2822 2005-12-22
1902883721 Paula Anne Guerra Family Medicine 4745 S 3200 W, Salt Lake City, UT 84118-2822 2005-12-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225527500 Hoan K Doan Case Manager/Care Coordinator 3809 West 6200 South, Kearns, UT 84118 2018-05-02
1750664785 Giao L Tran Pharmacist 5586 W 6200 S, Slc, UT 84118 2011-09-26
1982913406 Brent James Seely Counselor 5934 S 8400 W, Kearns, UT 84118 2010-10-01
1558593830 Easterseals-goodwill Northern Rocky Mountain, Inc. Early Intervention Provider Agency 5242 South 4820 West, Att Janet Wade, Kearns, UT 84118 2009-08-20
1063643120 Phung Matthews Pharmacist 1837 West 4700 South, Taylorsville, UT 84118 2009-08-06
1689824963 Mary Candace Christensen Social Worker 3703 West 6200 South, Valley Mental Health Artec - Therapeutic Foster Care, Bennion, UT 84118 2008-09-24
1164695128 Life's Endeavour Chiropractor 2494 West Sharron Drive, Taylorsville, UT 84118 2008-04-10
1750585485 Wendy Kay Cotting Pediatrics Taylorsville Kidscare, 3845 W. 4700 S., Taylorsville, UT 84118 2007-06-14
1720102841 Wendy Lee Bingham Physical Therapist 3845 W. 4700 S., Ihc Taylorsville Health Center, Taylorsville, UT 84118 2007-03-16
1417028952 Terry Milo Hansen Optometrist 2828 West 4700 South, Suite D, West Valley City, UT 84118 2006-11-13
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1356957468 Aubrie Dawn Tilley Family Medicine 1741 E Imperial Park Ln, Salt Lake City, UT 84106-3379 2020-09-23
1457969834 Sandra Lee Porter Family Medicine 3979 S Jester Dr, Salt Lake City, UT 84123-1227 2020-07-21
1265057673 Onsite Care Clinics Family Medicine 230 S 500 E Ste 510, Salt Lake City, UT 84102-2028 2020-06-11
1467097071 Centric Physicians Intermountain Region, Pllc Family Medicine 7101 N Mesa Street #365, Salt Lake City, UT 84101-1603 2019-11-07
1760036024 Mindy Marie Wade Family Medicine 1950 E Fort Union Blvd, Salt Lake City, UT 84121-6894 2019-07-25
1841854338 Tandy Muse Family Medicine 4460 S Highland Dr Ste 400, Salt Lake City, UT 84124-3565 2019-04-30
1821561408 Terra Bowden Family Medicine 450 S 900 E Ste 175, Salt Lake City, UT 84102-2981 2019-01-07
1801379193 Country Corner Family Medicine Family Medicine 5460 W Clernates Dr, Salt Lake City, UT 84118-8526 2018-09-12
1396259008 Futura Medical Clinic Family Medicine 1407 W North Temple Ste 120, Salt Lake City, UT 84116-3187 2017-11-17
1255858734 Fjm Basecamp Family Medicine 185 S State St Ste 208, Salt Lake City, UT 84111-1558 2017-08-25
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Competitor

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City SALT LAKE CITY
Zip Code 84118

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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