MATRIX MEDICAL NETWORK OF UTAH,LLC (NPI# 1366737579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366737579 |
| Entity Type | Organization |
| Organization Name | MATRIX MEDICAL NETWORK OF UTAH,LLC |
| Practice Address |
2150 S 1300 E Ste 500 Salt Lake City UT 84106-4375 |
| Mailing Address |
9201 E Mountain View #220 Scottsdale AZ 85258-5172 |
| Practice Telephone | 4808621677 |
| Practice Fax Number | 4807187643 |
| Mailing Telephone | 4808621700 |
| Mailing Fax Number | 8775064560 |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2019-12-10 |
| Authorized Official Name | VICTORIA ALVAREZ (DIRECTOR, CREDENTIALING) |
| Authorized Official Telephone | 4808621695 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2150 S 1300 E STE 500 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84106-4375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205319985 | Stephanie Edsall | Counselor | 2150 S 1300 E Ste 500, Salt Lake City, UT 84106-4375 | 2018-09-10 |
| 1528544467 | Columbus Medical Services, LLC | Case Management | 2150 S 1300 E Ste 500, Salt Lake City, UT 84106 | 2018-07-13 |
| 1144764705 | Rio Maestas | Counselor | 2150 S 1300 E Ste 500, Salt Lake City, UT 84106-4375 | 2016-12-15 |
| 1235589581 | The Worth of One Soul, Inc. | Social Worker | 2150 S 1300 E Ste 500, Salt Lake City, UT 84106-4375 | 2016-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801400015 | Tyra Mae Vance | Counselor | 3375 S 880 E, Salt Lake City, UT 84106 | 2020-09-04 |
| 1316596554 | Adam Davies | Pharmacist | 1280 E Stringham Ave., Salt Lake City, UT 84106 | 2019-09-10 |
| 1558919142 | University of Utah | Pharmacy | 1280 E. Stringham Ave, Suite 101, Salt Lake City, UT 84106 | 2019-08-28 |
| 1588174064 | Aaron Potts | Naturopath | 1945 1100 E, #100, Salt Lake City, UT 84106 | 2017-10-10 |
| 1801335005 | Gretchen Dennison | Nurse Practitioner | 2138 S Highland Dr, Salt Lake City, UT 84106 | 2017-02-21 |
| 1376095794 | Jeannette Daneals | Naturopath | 1945 South 1100 East, Suite 100, Salt Lake City, UT 84106 | 2016-11-02 |
| 1073908703 | Tracey Steinmetz | Massage Therapist | 3300 South 970 East, Suite 7, Salt Lake City, UT 84106 | 2015-03-31 |
| 1275949091 | Amy Deforest Edwards | Counselor | Jewish Family Service, 1111 E Brickyard Rd, Suite 218, Slc, UT 84106 | 2014-07-02 |
| 1194138636 | Hillary Lowe Taggart | Nurse Practitioner | 3369 S Highland Dr, Salt Lake City, UT 84106 | 2014-06-03 |
| 1487086617 | Herald R. Clark, Dds | Dentist | 3643 S. Highland Drive, Salt Lake City, UT 84106 | 2013-07-30 |
| Find all providers in zip 84106 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174936140 | Elizabeth Shade Cardenas | Nurse Practitioner | 500 Foothill Drive #182h, Veterans Healthcare Administration, Salt Lake City, UT 84148 | 2014-06-08 |
| 1265612097 | Solo Clinical Services LLC | Nurse Practitioner | 1864 Downington Ave, Salt Lake City, UT 84108-2912 | 2007-11-09 |
| 1730201245 | William Andrew Schwarz II | Nurse Practitioner | 4701 W 2100 S Bldg 3, C/o Cr England and Lakeside Medical Clinic, Salt Lake City, UT 84120-1223 | 2007-04-04 |
| 1700929338 | Cristine Tuttle | Nurse Practitioner | 375 Chipeta Way Suita A200, University of Utah Hospitals and Clinics, Sleep Center, Salt Lake City, UT 84108-0001 | 2007-02-14 |
| 1972650836 | Valerie Jean Flattes | Nurse Practitioner | Npha 4568 S Highland Drive, #290, Salt Lake City, UT 84117 | 2007-01-04 |
| 1184717878 | Kathleen Hooten | Nurse Practitioner | 555 Foothill Dr Rm 301, Salt Lake City, UT 84112-1106 | 2006-10-02 |
| 1841225372 | Janet E Tulloch | Nurse Practitioner | Va Slc Health Care Sytem 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2006-07-12 |
| 1770556946 | Jane Elizabeth Bell | Nurse Practitioner | George E Whalen Va Med Center (111p), 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2006-02-08 |
| 1639796477 | Lacey A Cooper | Nurse Practitioner | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-06-27 |
| 1063067346 | Samuel Harry Van Rensburg | Nurse Practitioner | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2019-08-05 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84106 |
Please comment or provide details below to improve the information on MATRIX MEDICAL NETWORK OF UTAH,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.