EVERGREEN MEDICAL, INC. (NPI# 1316160534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1316160534 |
Entity Type | Organization |
Organization Name | EVERGREEN MEDICAL, INC. |
Other Organization Name | THE SMART CLINIC |
Practice Address |
10011 Centennial Pkwy Suite 500 Sandy UT 84070-4156 |
Practice Telephone | 8016767627 |
Practice Fax Number | 8016767629 |
Mailing Telephone | 8016767627 |
Mailing Fax Number | 8016767629 |
Enumeration Date | 2007-04-10 |
Last Update Date | 2008-03-05 |
Authorized Official Name | MRS. MARCI MERRILL (OFFICE MANAGER) |
Authorized Official Telephone | 8016767627 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MA | DR NPI | 1013980119 | 01 |
UT | DR NPI | 1285604462 | 01 |
UT | DR NPI | 1750351847 | 01 |
UT | DR NPI | 1649377540 | 01 |
Other Name | Type Code |
---|---|
the SMART Clinic | Doing Business As Name - Organization |
Entity Type | Entity Name | Entity Address |
---|---|---|
Washington State Corporations | EVERGREEN MEDICAL, INC | 3340 Beity Rd, Valley, WA 99181 |
Street Address |
10011 CENTENNIAL PKWY SUITE 500 |
City | SANDY |
State | UT |
Zip Code | 84070-4156 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003812116 | Gary Anthony Carter | Dentist | 10011 Centennial Pkwy, Ste 240, Sandy, UT 84070-4156 | 2005-06-23 |
1558676957 | Erickson Surgical Consulting Pllc | Obstetrics & Gynecology | 10011 Centennial Pkwy, Suite 150, Sandy, UT 84070-4156 | 2010-08-10 |
1407002496 | Jacob Scott Hamblin | Dentist | 10011 Centennial Pkwy, Suite 540, Sandy, UT 84070-4156 | 2008-08-11 |
1649452475 | Paul W Winterton Md PC | Orthopaedic Surgery | 10011 Centennial Pkwy, #230, Sandy, UT 84070-4156 | 2007-12-04 |
1215130182 | Salt Lake Women's Center | Specialist | 10011 Centennial Pkwy, Suite 350, Sandy, UT 84070-4156 | 2007-06-07 |
1508076928 | Paul E. Harrison | Dermatology | 10011 Centennial Pkwy, Ste 200, Sandy, UT 84070-4156 | 2007-05-23 |
1750418612 | Trueskin Dermatology & Surgery Inc | Dermatology | 10011 Centennial Pkwy, Suite 200, Sandy, UT 84070-4156 | 2007-02-27 |
1669517751 | Erik Richard Rooklidge | Dentist | 10011 Centennial Pkwy, Suite 250, Sandy, UT 84070-4156 | 2007-02-20 |
1588725097 | Robert Chidester | Dentist | 10011 Centennial Pkwy, Suite 330, Sandy, UT 84070-4156 | 2006-12-12 |
1417017740 | Justin Carl Wilcox | Physician Assistant | 10011 Centennial Pkwy, Ste. 150, Sandy, UT 84070-4156 | 2006-12-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639777568 | Megan Komatsu Inc. | Social Worker | 10815 700 East, Sandy, UT 84070 | 2020-10-13 |
1841803137 | Anywhere Care | Nurse Practitioner | 9980 S. 300 W. Suite 200, Sandy, UT 84070 | 2020-08-26 |
1245840552 | Kirandeep Kaur | Psychologist | 9678 700 E # 102, Sandy, UT 84070 | 2020-08-03 |
1740890961 | Elizabeth Lowe Madsen | Counselor | 9678 700 East Suite 102, Sandy, UT 84070 | 2020-08-03 |
1417597188 | Hayley Burr | Counselor | 8706 700 E, Suite 205, Sandy, UT 84070 | 2020-01-10 |
1821656422 | Karen Ritchie | Counselor | 9192 South 300 West, Sandy, UT 84070 | 2019-05-30 |
1679068159 | Derek Livingston | Counselor | 11075 State St #35, Sandy, UT 84070 | 2018-06-27 |
1891283735 | Alta Rx LLC. | Pharmacy | 9883 South 500 West, Sandy, UT 84070 | 2018-04-26 |
1790273704 | The Addiction Medicine Physicians Group, LLC | Registered Nurse | 9160 S 300 E. Ste 25, Sandy, UT 84070 | 2018-04-25 |
1841794765 | Caryn Beazel | Physical Therapist | 9350 150 E, Sandy, UT 84070 | 2018-03-23 |
Find all providers in zip 84070 |
Taxonomy Code | 208VP0014X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pain Medicine |
Specialization | Interventional Pain Medicine |
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063721850 | Alta Pain Physicians, Pllc | Pain Medicine | 11333 S 1000 E, #102, Sandy, UT 84094-5428 | 2010-09-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972862605 | Intermountain Pain Management and Injury, Inc | Pain Medicine | 6575 S Redwood Rd, St 201, Taylorsville, UT 84123-5688 | 2012-05-15 |
1285958439 | Advanced Spine Pain Specialists | Pain Medicine | 286 N Gateway Dr Ste 201, Providence, UT 84332-5603 | 2010-03-17 |
1619907490 | Kyle Shigeru Matsumura | Pain Medicine | 6750 S Highland Drive, Ste 100, Cottonwood Heights, UT 84121 | 2006-07-04 |
1326665829 | Wasatch Wellness Center LLC | Pain Medicine | 1215 S 1680 W, Orem, UT 84058-4939 | 2020-06-30 |
1689226391 | Utah Intermountain Pain Management | Pain Medicine | 8822 S Redwood Rd Ste 113, West Jordan, UT 84088-9341 | 2019-07-12 |
1568909836 | Glacier Peak Pain Care Pllc | Pain Medicine | 1407 N 2000 W, Clinton, UT 84015-8562 | 2017-01-25 |
1073959714 | Wasatch Sports, Spine & Pain Treatment Center Pllc | Pain Medicine | 680 E Main St, 202, Lehi, UT 84043-2241 | 2013-05-21 |
1841531340 | Wasatch Pain Solutions, PC | Pain Medicine | 661 W 10600 S, South Jordan, UT 84095-8524 | 2013-03-07 |
1376821587 | Canyon Ridge Pain and Spine PC | Pain Medicine | 1551 Renaissance Towne Dr, Suite 460, Bountiful, UT 84010-7667 | 2011-07-22 |
1861643330 | Craig William Davis | Pain Medicine | 3181 W 9000 So, West Jordan, UT 84088 | 2008-10-02 |
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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.