PROVO DIALYSIS CENTER UNIVERSITY OF UTAH (NPI# 1194824201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194824201 |
| Entity Type | Organization |
| Organization Name | PROVO DIALYSIS CENTER UNIVERSITY OF UTAH |
| Other Organization Name | UNIVERSITY OF UTAH |
| Practice Address |
1675 N Freedom Blvd Provo UT 84604-2540 |
| Mailing Address |
Po Box 27071 Salt Lake City UT 84127-0071 |
| Practice Telephone | 8013730167 |
| Practice Fax Number | 8013741989 |
| Mailing Telephone | 8015818578 |
| Mailing Fax Number | 8013741989 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2014-05-21 |
| Authorized Official Name | MR. STEVEN L HEMMING (PROGRAM ADMINISTRATOR) |
| Authorized Official Telephone | 8015818573 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
2004-ESRD-228 | UT | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| University of Utah | Doing Business As Name - Organization |
| Street Address |
1675 N FREEDOM BLVD |
| City | PROVO |
| State | UT |
| Zip Code | 84604-2540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912991738 | Northwest Orthotics & Prosthetics | Durable Medical Equipment & Medical Supplies | 1675 N Freedom Blvd, Ste 12 C, Provo, UT 84604-2540 | 2005-09-08 |
| 1942588082 | Keith J. Clayton, M.d., P.C. | Pediatrics | 1675 N Freedom Blvd, Ste 9c, Provo, UT 84604 | 2011-07-22 |
| 1851693808 | Russell James Bailey | Psychologist | 1675 N Freedom Blvd, Suite 2b2, Provo, UT 84604-2540 | 2010-11-24 |
| 1174778450 | Matthew Joseph Clayton | Pediatrics | 1675 N Freedom Blvd, Ste 9c, Provo, UT 84604-2540 | 2008-11-30 |
| 1932353539 | Now I Can Foundation | Clinic/Center | 1675 N Freedom Blvd, Suite 10b, Provo, UT 84604-2540 | 2008-11-10 |
| 1639321540 | Elizabeth Ann Jensen | Physical Therapist | 1675 N Freedom Blvd, Building 10b, Provo, UT 84604-2540 | 2008-10-22 |
| 1336364629 | Darren Wesley Gardner | Dentist | 1675 N Freedom Blvd, Ste 12a, Provo, UT 84604-2540 | 2007-04-13 |
| 1184847063 | New Horizon Women's Care, LLC | Internal Medicine | 1675 N Freedom Blvd, Suite 3, Provo, UT 84604-2540 | 2007-04-10 |
| 1336219906 | Kent Blad | Nurse Practitioner | 1675 N Freedom Blvd, Bldg 3, Provo, UT 84604-2540 | 2006-11-09 |
| 1265452163 | Damon Monson Faust | Chiropractor | 1675 N Freedom Blvd, 7a, Provo, UT 84604-2540 | 2006-07-20 |
| Find all providers in the same location | ||||
| 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 | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811139561 | Total Renal Care Inc | Clinic/Center | 1055 N 500 W Ste 222, Provo, UT 84604 | 2009-03-26 |
| 1114981107 | Total Renal Care Inc | Clinic/Center | 1055 N 500 W Ste 221, Provo, UT 84604-3305 | 2006-04-14 |
| 1831153840 | No Roll Up Timpanogos LLC | Clinic/Center | 1055 N 500 W, Ste 222, Provo, UT 84604-3329 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587571 | Bmh Kidney Care LLC | Clinic/Center | 802 S 200 W Ste B, Blanding, UT 84511-3910 | 2020-10-29 |
| 1053956391 | Hegan Dialysis, LLC | Clinic/Center | 490 S State St, Orem, UT 84058-6302 | 2019-11-11 |
| 1811554124 | Pomme Dialysis, LLC | Clinic/Center | 1250 W Sandalwood Dr, Lehi, UT 84043-4615 | 2019-05-22 |
| 1992223556 | Wakonda Dialysis LLC | Clinic/Center | 555 W State Road 164 Ste 101, Salem, UT 84653-5732 | 2017-09-05 |
| 1831627223 | Fresenius Medical Care Provo, LLC | Clinic/Center | 135 South Orem Blvd, Ste 101, Orem, UT 84058-3006 | 2017-05-30 |
| 1407394463 | Fresenius Medical Care Pleasant View, LLC | Clinic/Center | 1735 West 2700 North, Farr West, UT 84404-1208 | 2017-02-09 |
| 1356897961 | Fresenius Medical Care Utah, LLC | Clinic/Center | 4101 W Pioneer Pkwy, Suite 101, West Valley City, UT 84120-2050 | 2016-09-01 |
| 1770951030 | Liberty Dialysis-weber County, LLC | Clinic/Center | 475 East 40th St, Suite 110, South Ogden, UT 84403-1852 | 2015-09-03 |
| 1558746727 | Fresenius Medical Care Riverton, LLC | Clinic/Center | 12523 South Meadow Creek Drive, Riverton, UT 84065-7259 | 2015-07-29 |
| 1093199135 | Fresenius Medical Care Cedar City, LLC | Clinic/Center | 1320 North Main Street, Cedar City, UT 84721 | 2015-07-18 |
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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.