COMPREHENSIVE MEDICAL MANAGEMENT, PC (NPI# 1104060714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104060714 |
| Entity Type | Organization |
| Organization Name | COMPREHENSIVE MEDICAL MANAGEMENT, PC |
| Other Organization Name | THE SPINE, ORTHOPEDIC AND PAIN CENTER |
| Practice Address |
4052 W Pioneer Parkway Suite 208 West Valley City UT 84120 |
| Practice Telephone | 8019551232 |
| Practice Fax Number | 8019551543 |
| Mailing Telephone | 8019551232 |
| Mailing Fax Number | 8019551543 |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-07-06 |
| Authorized Official Name | DR. TIMOTHY GRANGE (OWNER) |
| Authorized Official Telephone | 8019551232 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
89180152-1205 | UT | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| The Spine, Orthopedic and Pain Center | Doing Business As Name - Organization |
| Street Address |
4052 W PIONEER PARKWAY SUITE 208 |
| City | WEST VALLEY CITY |
| State | UT |
| Zip Code | 84120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891349213 | Eli Kenny | Physical Therapist | 336 South 4155 West, West Valley City, UT 84120 | 2019-07-25 |
| 1841765377 | Wan Jen Horng | Pharmacist | 4052 Pioneer Parkway, # 111, West Valley City, UT 84120 | 2018-10-11 |
| 1841784220 | Andrea Savas | Physical Therapist | 3460 South 4155 West, West Valley City, UT 84120 | 2018-06-19 |
| 1235628223 | Meds In Motion, LLC | Pharmacy | 12101 S State St, Suite 101a, Draper, UT 84120 | 2018-05-04 |
| 1316477383 | Kendra Lindsey | Social Worker | 4052 W 3390 S Suite 105, West Valley City, UT 84120 | 2017-06-13 |
| 1154726842 | National Vision, Inc. | Technician/Technologist | 2569 South 5600 West, Ste A 550, West Valley, UT 84120 | 2014-10-24 |
| 1154637825 | Granger Pediatric Dentistry | Clinic/Center | 3725 W. 4100 S., Suite #260, West Valley City, UT 84120 | 2010-08-19 |
| 1336384197 | Bamileke Sinju Sinju | Home Health | 3712 South Golden Grain Cir, West Valley City, UT 84120 | 2008-12-09 |
| 1164673331 | Empowered for Life, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5004 West Janette Drive, West Valley City, UT 84120 | 2008-10-07 |
| 1679731319 | Exodus Healthcare Network Pllc | Clinic/Center | 3336 South Pioneer Parkway, Suite 201, West Valley, UT 84120 | 2008-05-29 |
| Find all providers in zip 84120 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013071885 | Charles Mikell Bova | Physical Medicine & Rehabilitation | 3336 Pioneer Pkwy, Suite 204, West Valley City, UT 84120-2000 | 2006-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194144329 | Austin Lebron Albright | Physical Medicine & Rehabilitation | 6360 S 3000 E Ste 200, Salt Lake City, UT 84121-6925 | 2014-04-15 |
| 1255691986 | Gregory Lyman Condie | Physical Medicine & Rehabilitation | 3838 S 700 E # 300, Slc, UT 84106-1466 | 2012-05-29 |
| 1407026420 | Qamar Khan | Physical Medicine & Rehabilitation | 661 W 10600 S, South Jordan, UT 84095-8524 | 2008-03-05 |
| 1942492079 | Edgar Clinton Goldston Jr. | Physical Medicine & Rehabilitation | 175 North Medical Drive East, Salt Lake City, UT 84132-2303 | 2007-08-13 |
| 1871799528 | Cole W Robinson | Physical Medicine & Rehabilitation | 860 N Main St Ste B, Richfield, UT 84701-1840 | 2007-06-21 |
| 1285673434 | David James Peifer | Physical Medicine & Rehabilitation | George E. Wahlen Veterans Administration Medical C, 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2006-06-05 |
| 1154312197 | Bradley Dryden Root | Physical Medicine & Rehabilitation | 1424 E Foremaster Dr Ste 120, St George, UT 84790-5844 | 2005-10-31 |
| 1225036064 | Brian K Olenslager | Physical Medicine & Rehabilitation | 3585 N University Ave, Ste 150, Provo, UT 84604-6601 | 2005-07-13 |
| 1861490278 | Corey D Anden | Physical Medicine & Rehabilitation | 4403 Harrison Blvd Ste 1875, Ogden, UT 84403-3325 | 2005-07-09 |
| 1699148197 | Ihc Health Services Inc | Physical Medicine & Rehabilitation | 412 W 800 N, Orem, UT 84057-3728 | 2015-11-05 |
| Find all providers with the same taxonomy | ||||
| City | WEST VALLEY CITY |
| Zip Code | 84120 |
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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.