UTAH KIDNEY CLINIC LLC (NPI# 1013520154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013520154 |
Entity Type | Organization |
Organization Name | UTAH KIDNEY CLINIC LLC |
Practice Address |
4345 Harrison Blvd Ste 101 Ogden UT 84403-3103 |
Mailing Address |
1820 E 17th St Ste 330 Idaho Falls ID 83404-6400 |
Practice Telephone | 7372079197 |
Practice Fax Number | 8449460909 |
Enumeration Date | 2020-08-28 |
Last Update Date | 2020-08-28 |
Authorized Official Name | MELISSA JOHNSON (CREDENTIALING SPECIALIST) |
Authorized Official Telephone | 7372079197 |
Authorized Official Credential | CPB |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
Street Address |
4345 HARRISON BLVD STE 101 |
City | OGDEN |
State | UT |
Zip Code | 84403-3103 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235744632 | Megan Louise Larkins | Specialist/Technologist | 4000 Brinker Ave. The Apartments., Apartment 15, Ogden, UT 84403 | 2020-09-11 |
1154959062 | Joshua Clifford Hansen | Student in an Organized Health Care Education/Training Program | 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 | 2020-03-28 |
1346895935 | Positional Release Therapy Institute LLC | Specialist/Technologist | 1702 E. 5600 S., Ogden, UT 84403 | 2019-08-09 |
1841842077 | Braken Wooden | Chiropractor | 1893 Skyline Dr., Suite 204, South Ogden, UT 84403 | 2019-07-09 |
1023670569 | Wasatch Advanced Dental Care LLC | Dentist | 3590 Harrison Blvd Suite #1, Ogden, UT 84403 | 2019-07-05 |
1194237636 | Marci Niemeyer | Physician Assistant | 5929 Fashion Point Dr Ste 101, South Ogden, UT 84403 | 2017-10-24 |
1578081949 | Stephanie Jensen | Specialist/Technologist | 1473 36th Street, Ogden, UT 84403 | 2017-09-06 |
1891213385 | Forrest Sutherland | Specialist/Technologist | 1075 E 41st St., Ogden, UT 84403 | 2017-09-05 |
1184159022 | Nicole Lee Van Tassell | In Home Supportive Care | 1496 East 5600 South, Unit 6, Ogden, UT 84403 | 2017-04-28 |
1265889166 | Modern Dental Professionals Ut, PC | Dentist | 5974 S. Fashion Pointe Drive, Suite 210, South Ogden, UT 84403 | 2016-05-20 |
Find all providers in zip 84403 |
Taxonomy Code | 207RN0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Nephrology |
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851455224 | Bonneville Dialysis Center | Internal Medicine | 5575 S 500 E, Ogden, UT 84405-6907 | 2006-12-20 |
1225040231 | Northern Utah Nephrology, LLC | Internal Medicine | 425 E 5350 S, Suite 320, Ogden, UT 84405-6946 | 2006-08-12 |
1164424750 | Adhish K Agarwal | Internal Medicine | 4403 Harrison Blvd, Suite 2635, Ogden, UT 84403-3244 | 2005-08-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134588957 | St George Kidney Care LLC | Internal Medicine | 624 S 1000 E Ste 103, St George, UT 84790-5902 | 2016-02-22 |
1952560351 | Aylin Rachel Rodan | Internal Medicine | 85 Medical Dr, Room 223, Salt Lake City, UT 84112-1100 | 2008-06-02 |
1467644286 | Kristie Elizabeth Jones | Internal Medicine | 5315 Adams Ave Pkwy Ste A, South Ogden, UT 84405-4772 | 2007-08-15 |
1578761003 | Hasan Joseph Salameh | Internal Medicine | 650 E 4500 S Ste 210, Salt Lake City, UT 84107-4520 | 2007-07-05 |
1801807144 | Jerald P Boseman | Internal Medicine | 121 S Orem Blvd Ste 103, Orem, UT 84058 | 2006-08-11 |
1801824438 | Sey M Lau | Internal Medicine | 3702 S State St Ste 107, Salt Lake City, UT 84115-5096 | 2006-06-30 |
1124064845 | Terry C Hammond | Internal Medicine | 1175 E 50 S Ste 161, American Fork, UT 84003-2845 | 2006-06-21 |
1679533012 | Nephrology Medical Associates of Georgia LLC | Internal Medicine | 880 E 3900 S, Ste B, Salt Lake City, UT 84107-2151 | 2006-03-27 |
1841271491 | Sheetal Shah | Internal Medicine | 3181 W 9000 S, West Jordan, UT 84088-5610 | 2005-11-10 |
1366444051 | Carlos Alberto Mercado | Internal Medicine | 624 S 1000 E, Ste 103, St George, UT 84790-5902 | 2005-08-11 |
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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.