WHITE TREE MEDICAL CONSULTANTS LLC (NPI# 1497204903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497204903 |
| Entity Type | Organization |
| Organization Name | WHITE TREE MEDICAL CONSULTANTS LLC |
| Practice Address |
10437 S Jordan Gtwy South Jordan UT 84095 |
| Mailing Address |
Po Box 709391 Sandy UT 84070-9391 |
| Practice Telephone | 8018770705 |
| Practice Fax Number | 8013355957 |
| Mailing Telephone | 8018770705 |
| Mailing Fax Number | 8013355957 |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2018-08-27 |
| Authorized Official Name | CL CANFIELD (OWNER) |
| Authorized Official Telephone | 8018770705 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 163WA0400X |
Registered Nurse Specialization: Addiction (Substance Use Disorder) |
Nursing Service Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| N | 310500000X | Intermediate Care Facility, Mental Illness | Nursing & Custodial Care Facilities | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
10437 S JORDAN GTWY |
| City | SOUTH JORDAN |
| State | UT |
| Zip Code | 84095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558418673 | Bryan Vern Sonntag | Plastic Surgery | 10437 S Jordan Gtwy, South Jordan, UT 84095-3915 | 2007-01-03 |
| 1326519018 | Traci B Olsen-lujan | Nurse Practitioner | 10437 S Jordan Gtwy, South Jordan, UT 84095-3915 | 2018-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033745393 | Beverly Laraine Williams | Social Worker | 11260 S River Heights Drive, South Jordan, UT 84095 | 2020-03-19 |
| 1265902902 | Sarah Richele Kelley | Specialist/Technologist | 10236 Alder Grovey Way, South Jordan, UT 84095 | 2018-11-26 |
| 1326528837 | Kristi Couse | Massage Therapist | 10679 S 2200 W Apt 2, South Jordan, UT 84095 | 2018-08-15 |
| 1821516063 | River Crossing Dental Professional Corporation | Clinic/Center | 12427 South 4000 West, Suite #200, Riverton, UT 84095 | 2017-09-08 |
| 1245755719 | Staci Stout | Dental Hygienist | 3113 W Swiss Pass Cir, South Jordan, UT 84095 | 2017-08-07 |
| 1437698750 | Ryan Sears | Dentist | 10894 So. River Front Parkway, South Jordan, UT 84095 | 2017-02-20 |
| 1366989931 | Ultimate Sports Regenerative Medicine | Chiropractor | 1098 W. South Jordan Pkwy, Suite 101, South Jordan, UT 84095 | 2017-01-20 |
| 1306393889 | Tal Quirl | Optometrist | 3571 W. 10400 S., South Jordan, UT 84095 | 2016-09-01 |
| 1023562667 | Sevon Taroian | Social Worker | 11260 River Heights Drive, South Jordan, UT 84095 | 2016-08-11 |
| 1952762932 | Megan Buckley | Developmental Therapist | 881 Baxter Drive, Ste 100, South Jordan, UT 84095 | 2016-03-17 |
| Find all providers in zip 84095 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089607 | Mat Ventures | Family Medicine | 8388 S Wasatch Blvd, Cottonwood Heights, UT 84121-6075 | 2020-03-26 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1033742994 | Mobile Vivitrol | Family Medicine | 46 N Foxhill Rd, North Salt Lake, UT 84054-3027 | 2020-02-19 |
| 1518516210 | Cuicui Zhang | Family Medicine | 8686 S 1300 E # L102l104, Sandy, UT 84094-1947 | 2019-09-05 |
| 1275034084 | Southern Utah Health & Recovery | Family Medicine | 260 W Saint George Blvd Ste 202b, St George, UT 84770-3792 | 2018-02-27 |
| 1003070111 | Robert Joel Bush | Family Medicine | 74 S 360 E, American Fork, UT 84003 | 2008-07-17 |
| 1376577049 | Sean Anthony Ponce | Family Medicine | 3802 S 700 E, Salt Lake City, UT 84106-1182 | 2006-07-10 |
| 1538114889 | Daniel Clyde Cummings | Family Medicine | 694 N 1890 W Unit 44a, Provo, UT 84601-1327 | 2006-05-24 |
| 1457355869 | Charles Wesley Walton | Family Medicine | 11286 N Tamarack Dr, Highland, UT 84003-9595 | 2005-06-13 |
| 1174136113 | Amir Haskic | Family Medicine | 2870 E 3300 S, Salt Lake City, UT 84109-2821 | 2020-08-28 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH JORDAN |
| Zip Code | 84095 |
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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.