ASHLEY VALLEY PHYSICIAN PRACTICE LLC (NPI# 1164937645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164937645 |
| Entity Type | Organization |
| Organization Name | ASHLEY VALLEY PHYSICIAN PRACTICE LLC |
| Other Organization Name | ASHLEY VALLEY WOMEN'S HEALTH |
| Practice Address |
150 W 100 N Vernal UT 84078-2036 |
| Mailing Address |
330 Seven Springs Way Brentwood TN 37027-5098 |
| Practice Telephone | 4357896962 |
| Practice Fax Number | 4357896961 |
| Mailing Telephone | 6159207000 |
| Mailing Fax Number | 6159208775 |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2020-09-03 |
| Authorized Official Name | KATHY TEAGUE (SECRETARY) |
| Authorized Official Telephone | 6159207000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Ashley Valley Women's Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871834960 | Ashley Valley Physician Practice LLC | Clinic/Center | 409 S 200 E, Roosevelt, UT 84066-3314 | 2013-03-14 |
| 1255568564 | Ashley Valley Physician Practice LLC | Orthopaedic Surgery | 175 N 100 W, Suite 204, Vernal, UT 84078-2049 | 2009-06-12 |
| Street Address |
150 W 100 N |
| City | VERNAL |
| State | UT |
| Zip Code | 84078-2036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518062066 | Ashley Regional Medical Ctr Ekg Group | General Acute Care Hospital | 150 W 100 N, Vernal, UT 84078-1907 | 2006-09-13 |
| 1548874969 | Bruce A Piispanen | Occupational Therapist | 150 W 100 N, Vernal, UT 84078-2036 | 2020-09-02 |
| 1518591585 | Kara Lee Page Young | Speech-Language Pathologist | 150 W 100 N, Vernal, UT 84078-2036 | 2020-02-27 |
| 1770131591 | Sarah Elizabeth Olsen | Speech-Language Pathologist | 150 W 100 N, Vernal, UT 84078-2036 | 2019-08-27 |
| 1710533369 | Linda Mcclellan | Dietitian, Registered | 150 W 100 N, Vernal, UT 84078-2036 | 2019-08-09 |
| 1467929232 | Justin Aaron Benson | Speech-Language Pathologist | 150 W 100 N, Vernal, UT 84078-2036 | 2018-10-30 |
| 1578085320 | Jenny Lynette Henderson | Dietitian, Registered | 150 W 100 N, Vernal, UT 84078-2036 | 2017-07-13 |
| 1538512066 | Russell J Erickson | Physical Therapist | 150 W 100 N, Vernal, UT 84078-2036 | 2016-07-20 |
| 1306299839 | Justin R Watkins | Physical Therapist | 150 W 100 N, Vernal, UT 84078-2036 | 2016-07-20 |
| 1275889560 | Benjamin J Veltri Md Pllc | Surgery | 150 W 100 N, Suite S102, Vernal, UT 84078-2036 | 2012-07-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205479748 | Wade Oliver Moulton | Pharmacist | 1080 W Hwy 40, Vernal, UT 84078 | 2019-10-28 |
| 1841610383 | Allegiance Addiction Recovery Center | Substance Abuse Rehabilitation Facility | 4430 N Little Valley Road, Vernal, UT 84078 | 2014-04-23 |
| 1689008773 | Ashley Valley Physician Practice, LLC | Occupational Therapist | 1680 W Highway 40 Ste 202, Vernal, UT 84078 | 2013-08-26 |
| 1528371796 | Terry L Smith | Counselor | 1140 W 500 S #9, Vernal, UT 84078 | 2010-07-16 |
| 1619280880 | Cicile M Rios | Counselor | 1140 W 800 S #9, Vernal, UT 84078 | 2010-07-16 |
| 1265754840 | Marjorie Elaine Gardner | Licensed Practical Nurse | 133 S 500 East, Vernal, UT 84078 | 2010-02-23 |
| 1528205853 | Robert Kirkham Jolley | Dentist | 40 West 100 North, Vernal, UT 84078 | 2009-01-08 |
| 1740482025 | Ashley Valley Physician Practice, LLC | Family Medicine | 175 N. 100 W., Suite 202, Vernal, UT 84078 | 2007-05-31 |
| 1265646459 | Ashley Valley Medical Center | Pharmacy | 151 W. 200 N., Vernal, UT 84078 | 2007-05-09 |
| 1629122692 | Brian Prentice Callahan | Dentist | 779 West Us Highway 40, Vernal, UT 84078 | 2007-01-23 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831336825 | Tarheel Obgyn PC | Obstetrics & Gynecology | 150 W 100 N, Ste S103, Vernal, UT 84078-2036 | 2009-01-13 |
| 1558559054 | Richard V Thomas Md PC | Obstetrics & Gynecology | 175 N 100 W, Ste 105, Vernal, UT 84078-2049 | 2007-10-09 |
| 1154406163 | John L Griffith PC | Obstetrics & Gynecology | 175 N 100 W, Ste 103, Vernal, UT 84078-2049 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144753013 | Jessica Kaplan | Obstetrics & Gynecology | University of Utah University Hospital, 50 N Medical Drive, Salt Lake City, UT 84132-0001 | 2017-04-07 |
| 1326571621 | Kylie Measom Soffe | Obstetrics & Gynecology | Ob Gyn Administration 30 N 1900 E Rm 2b200, Salt Lake City, UT 84132-2101 | 2017-04-04 |
| 1326492109 | Pennington Medical Center | Obstetrics & Gynecology | 3507 N University Ave Ste 175, Provo, UT 84604-6692 | 2016-04-19 |
| 1629430046 | Chadwick Miles Densley | Obstetrics & Gynecology | 12842 South 3600 West, Suite 200, Riverton, UT 84065 | 2016-03-24 |
| 1184090870 | Mountainstar Medical Group Timpanogos Specialty Care, LLC | Obstetrics & Gynecology | 1020 S 1100 W Ste B, Lehi, UT 84043-6041 | 2015-08-17 |
| 1639564016 | Kristen Hansord Lilja | Obstetrics & Gynecology | 82 S 1100 E Ste 305, Salt Lake City, UT 84102-4703 | 2015-04-01 |
| 1194119172 | Irina Cassimatis | Obstetrics & Gynecology | University of Utah Obgyn Dept, 30 N 1900 East. Room 2b200, Salt Lake City, UT 84132-0001 | 2015-03-26 |
| 1033509740 | Kathryn Fay | Obstetrics & Gynecology | 30 N 1900 E Rm 2a200, Salt Lake City, UT 84132-2209 | 2015-02-02 |
| 1932528676 | Aliye Runyan | Obstetrics & Gynecology | 30 North 1900 East 2a200, Dept of Obgyn, Salt Lake City, UT 84132 | 2014-04-09 |
| 1467870295 | Ashley Elizabeth Benson | Obstetrics & Gynecology | 30 N 9100 E, Room 2b200, Salt Lake City, UT 84132-0001 | 2014-03-29 |
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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.