UTAH GASTROENTEROLOGY P C (NPI# 1457393761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457393761 |
| Entity Type | Organization |
| Organization Name | UTAH GASTROENTEROLOGY P C |
| Other Organization Name | FKA MOUNTAIN WEST GASTROENTEROLOGY, P.C. |
| Practice Address |
620 East Medical Drive Suite 205 Bountiful UT 84010-5084 |
| Mailing Address |
6360 South 3000 East Suite 220 Salt Lake City UT 84121-6923 |
| Practice Telephone | 8012980057 |
| Practice Fax Number | 8012989765 |
| Mailing Telephone | 8019443199 |
| Mailing Fax Number | 8019443180 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2017-10-30 |
| Authorized Official Name | CHRISTINE MORRIS (CORPORATE ADMINISTRATOR) |
| Authorized Official Telephone | 8019443191 |
| Is Organization Subpart | Y |
| Parent Organization Name | UTAH GASTROENTEROLOGY P C |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | RAILROAD MEDICARE PIN | CD3562 | 01 |
| Other Name | Type Code |
|---|---|
| FKA Mountain West Gastroenterology, P.C. | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447662523 | Utah Gastroenterology P C | Internal Medicine | 74 E Kimball Lane, Suite 230, Draper, UT 84020-7735 | 2014-05-23 |
| 1871689562 | Utah Gastroenterology P C | Internal Medicine | 1187 E 3900 S, Salt Lake City, UT 84124-1201 | 2006-10-04 |
| 1972510717 | Utah Gastroenterology P C | Internal Medicine | 6360 South 3000 East, Suite 310, Salt Lake City, UT 84121 | 2006-08-02 |
| 1235676149 | Utah Gastroenterology P C | Internal Medicine | 3000 N Triumph Blvd, Suite 340, Lehi, UT 84043-4999 | 2017-01-30 |
| 1821465469 | Utah Gastroenterology P C | Internal Medicine | 13953 S Bangerter Pkwy, Draper, UT 84020 | 2015-08-31 |
| 1235464413 | Utah Gastroenterology P C | Internal Medicine | 12391 S 4000 W, Riverton, UT 84096-7012 | 2009-10-06 |
| 1255405957 | Utah Gastroenterology P C | Internal Medicine | 368 E Riverside Dr, Suite A, St George, UT 84790-6896 | 2006-11-17 |
| 1477627172 | Utah Gastroenterology P C | Internal Medicine | 5770 South 250 East, Suite 445, Murray, UT 84107 | 2006-11-17 |
| Street Address |
620 EAST MEDICAL DRIVE SUITE 205 |
| City | BOUNTIFUL |
| State | UT |
| Zip Code | 84010-5084 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164410403 | Mohamed Habibulla Sadiq | Psychiatry & Neurology | 620 East Medical Drive, Suite 150, Bountiful, UT 84010-5085 | 2005-10-11 |
| 1598952145 | Christopher Canale | Internal Medicine | 620 East Medical Drive, Suite 205, Bountiful, UT 84010-4916 | 2007-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225699192 | Jessyca K Willie | Behavior Technician | 415 S. Medical Drive Suite D101, Bountiful, UT 84010 | 2019-06-21 |
| 1336634344 | Shanna Joy Jaggers | Social Worker | 2333 S 200 E, Bountiful, UT 84010 | 2018-06-22 |
| 1447773171 | Live Life Alarms | Emergency Response System Companies | 640 South 500 West, Bountiful, UT 84010 | 2017-07-25 |
| 1902328842 | Hailey Embley | Behavior Technician | 415 Medical Drive D 101, Bountiful, UT 84010 | 2017-07-12 |
| 1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
| 1295287720 | Samantha Oslund | Speech-Language Pathologist | 415 Medical Dr Ste B102, Bountiful, UT 84010 | 2016-11-01 |
| 1750748273 | Jeremy Clark Morris | Dentist | 59 W 1600 N, Suite 110, Bountiful, UT 84010 | 2016-01-28 |
| 1629464706 | Shane James | Speech-Language Pathologist | 425 Medical Dr Ste 122, Bountiful, UT 84010 | 2015-04-15 |
| 1891186102 | Kenton Francis | Social Worker | 1355 North Main Street #1, Bountiful, UT 84010 | 2015-02-09 |
| 1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
| Find all providers in zip 84010 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215969837 | David Rayburn Moore | Internal Medicine | 620 East Medical Drive #205, Bountiful, UT 84010 | 2006-07-06 |
| 1598952145 | Christopher Canale | Internal Medicine | 620 East Medical Drive, Suite 205, Bountiful, UT 84010-4916 | 2007-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447662523 | Utah Gastroenterology P C | Internal Medicine | 74 E Kimball Lane, Suite 230, Draper, UT 84020-7735 | 2014-05-23 |
| 1992066799 | Brien Rex Miller | Internal Medicine | 368 E Riverside Dr Ste A, St George, UT 84790-6897 | 2012-06-07 |
| 1881928794 | Tranquil Living Center Group Corp | Internal Medicine | 189 N Highway 89, Ste C-10, N Salt Lake, UT 84054-2432 | 2009-09-24 |
| 1568592590 | Ihc Health Services Inc | Internal Medicine | 374 10th Ave, Suite 100, Salt Lake City, UT 84103-2823 | 2007-03-07 |
| 1306925433 | Robert F Miller | Internal Medicine | 1002 East South Temple, Ste 412, Salt Lake City, UT 84102 | 2006-11-02 |
| 1033209622 | Randall W. Burt | Internal Medicine | Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112 | 2006-10-13 |
| 1871689562 | Utah Gastroenterology P C | Internal Medicine | 1187 E 3900 S, Salt Lake City, UT 84124-1201 | 2006-10-04 |
| 1922113380 | Robert Shigeru Kiyomura | Internal Medicine | 2084 Robins Dr, Suite B, Layton, UT 84041-1100 | 2006-08-19 |
| 1760491054 | Vikram Garg | Internal Medicine | 1300 N 500 E Ste 340, Logan, UT 84341-2470 | 2006-08-05 |
| 1972510717 | Utah Gastroenterology P C | Internal Medicine | 6360 South 3000 East, Suite 310, Salt Lake City, UT 84121 | 2006-08-02 |
| Find all providers with the same taxonomy | ||||
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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.