CMS-1500 Box 24J / 33a • NPI
1235526682
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
213E00000X (CMS 48)
Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist
Box 32 Service Location & ZIP+4
6405 S 3000 E STE 300, SALT LAKE CITY, UT, 84121-6977
✓ 9-Digit EDI 837 ZIP+4 (84121-6977)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1235526682 (INNOVATION MEDICAL GROUP PC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1235526682 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | INNOVATION MEDICAL GROUP PC |
| Plain-English Specialty | Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist NUCC Code: 213E00000X (Podiatrist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 6405 S 3000 E STE 300, SALT LAKE CITY, UT, 84121-6977 |
| Practice Telephone / Fax | Tel: (801) 266-3113 | Fax: (801) 266-5633 |
| Administrative Mailing Address | 6405 S 3000 E STE 300, SALT LAKE CITY, UT, 84121-6977 |
| Enumeration & Last Sync | Enumerated: 2015-04-23 | CMS Record Updated: 2026-07-26 |
| Authorized Official | TAYLOR WRIGHT (CEO) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (213E00000X)
What Does Taxonomy Code 213E00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 213E00000X translates to:
"Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (INNOVATION MEDICAL GROUP PC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
163W00000X — Registered NursePlain English: Licensed & Credentialed Registered Nurse | State: N/A | License: Verified | Primary: Secondary |
163WI0500X — Registered Nurse, Infusion TherapyPlain English: Licensed & Credentialed Registered Nurse, Infusion Therapy | State: N/A | License: Verified | Primary: Secondary |
163WW0000X — Registered Nurse, Wound CarePlain English: Licensed & Credentialed Registered Nurse, Wound Care | State: N/A | License: Verified | Primary: Secondary |
207Q00000X — Family MedicinePlain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) | State: N/A | License: Verified | Primary: Secondary |
207ZP0102X — Pathology, Anatomic Pathology & Clinical PathologyPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Pathology, Anatomic Pathology & Clinical Pathology | State: N/A | License: Verified | Primary: Secondary |
208600000X — SurgeryPlain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) | State: N/A | License: Verified | Primary: Secondary |
213E00000X — PodiatristPlain English: Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist | State: N/A | License: Verified | Primary: Yes (Primary) |
213ES0103X — Podiatrist, Foot & Ankle SurgeryPlain English: Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Foot & Ankle Surgery | State: N/A | License: Verified | Primary: Secondary |
225X00000X — Occupational TherapistPlain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) | State: N/A | License: Verified | Primary: Secondary |
2471V0106X — Radiologic Technologist, Vascular-Interventional TechnologyPlain English: Licensed & Credentialed Radiologic Technologist, Vascular-Interventional Technology | State: N/A | License: Verified | Primary: Secondary |
332B00000X — Durable Medical Equipment & Medical SuppliesPlain English: Licensed & Credentialed Suppliers — Durable Medical Equipment & Medical Supplies | State: N/A | License: Verified | Primary: Secondary |
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: N/A | License: Verified | Primary: Secondary |
363LC1500X — Nurse Practitioner, Community HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Community Health | State: N/A | License: Verified | Primary: Secondary |
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: N/A | License: Verified | Primary: Secondary |
363LP0808X — Nurse Practitioner, Psych/Mental HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health | State: N/A | License: Verified | Primary: Secondary |
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