ADVANCED VEIN AND VASCULAR OF UTAH VALLEY LLC (NPI# 1093329427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093329427 |
| Entity Type | Organization |
| Organization Name | ADVANCED VEIN AND VASCULAR OF UTAH VALLEY LLC |
| Practice Address |
320 River Park Dr Ste 125 Provo UT 84604-6065 |
| Mailing Address |
6321 S Redwood Rd Ste 102 Taylorsville UT 84123-6799 |
| Practice Telephone | 3853888003 |
| Practice Fax Number | 3853444006 |
| Mailing Telephone | 3853888003 |
| Mailing Fax Number | 3853444006 |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-10-12 |
| Authorized Official Name | CHIP MUNFORD (CEO) |
| Authorized Official Telephone | 3853888003 |
| Authorized Official Credential | RCIS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians |
| Street Address |
320 RIVER PARK DR STE 125 |
| City | PROVO |
| State | UT |
| Zip Code | 84604-6065 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750368718 | Susanna Bean West | Nurse Anesthetist, Certified Registered | 320 River Park Dr Ste 125, Provo, UT 84604 | 2005-12-29 |
| 1407486012 | Nathan Huntsman | Registered Nurse | 320 River Park Dr Ste 125, Provo, UT 84604-6065 | 2020-01-22 |
| 1629516901 | Peaks Surgery Center, LLC | Clinic/Center | 320 River Park Dr Ste 125, Provo, UT 84604-6065 | 2017-02-07 |
| 1821290883 | Riverwoods Anesthesia Pllc | Anesthesiology | 320 River Park Dr Ste 125, Provo, UT 84604-5787 | 2007-06-01 |
| 1265554844 | Jared W Ollerton | Nurse Anesthetist, Certified Registered | 320 River Park Dr Ste 125, Provo, UT 84604-5787 | 2007-04-04 |
| 1063534550 | Rodney L Fisher | Nurse Anesthetist, Certified Registered | 320 River Park Dr Ste 125, Provo, UT 84604-5787 | 2007-04-04 |
| 1972624146 | Clark S Ashby | Anesthesiology | 320 River Park Dr Ste 125, Provo, UT 84604-5787 | 2007-04-03 |
| 1700983038 | Morgan K Grant | Anesthesiology | 320 River Park Dr Ste 125, Provo, UT 84604-6065 | 2006-09-20 |
| 1598731598 | Jed T Widdison | Nurse Anesthetist, Certified Registered | 320 River Park Dr Ste 125, Provo, UT 84604-6065 | 2006-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700490133 | Advanced Vein and Vascular of Northern Utah LLC | Internal Medicine | 810 S 100 W Ste 120, Logan, UT 84321-5845 | 2020-09-02 |
| 1326679952 | Advanced Vein and Vascular of Southern Utah LLC | Internal Medicine | 1251 Northfield Rd # 103, Cedar City, UT 84721-8622 | 2020-02-02 |
| 1407851488 | Tareq S Harb | Internal Medicine | 4403 Harrison Blvd Ste 3490, Ogden, UT 84403-3284 | 2005-06-16 |
| 1386272755 | Advanced Vein and Vascular of Salt Lake City LLC | Internal Medicine | 6321 S Redwood Rd Ste 102, Salt Lake City, UT 84123-6799 | 2020-03-31 |
| 1396390316 | American Heart and Vascular Institute PC | Internal Medicine | 5801 S Fashion Blvd Ste 120, Murray, UT 84107-8115 | 2019-08-06 |
| 1114361136 | Lee Anthony Linstroth | Internal Medicine | 30 N 1900 E, Room 4c104, Salt Lake City, UT 84132-0002 | 2013-04-21 |
| 1437446168 | Mountainstar Cardiology St Marks LLC | Internal Medicine | 1160 E 3900 S, Ste. 2000, Salt Lake City, UT 84124-1202 | 2011-07-01 |
| 1417283359 | Canyon Crest Heart & Health L.L.C. | Internal Medicine | 11762 S State St, Draper, UT 84020-7155 | 2009-10-28 |
| 1770720534 | Zubair Cardiovascular Inc | Internal Medicine | 82 South 1100 East, Suite 402, Salt Lake City, UT 84102 | 2009-01-15 |
| 1629221841 | Eric M Lindley | Internal Medicine | University of Utah, Salt Lake City, UT 84132-0001 | 2008-10-31 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ADVANCED VEIN AND VASCULAR OF UTAH VALLEY LLC.
| 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.