UNIVERSITY OF UTAH PEDIATRIC NEUROLOGY (NPI# 1508178476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508178476 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF UTAH PEDIATRIC NEUROLOGY |
| Practice Address |
3741 W 12600 S Riverton UT 84065-7215 |
| Mailing Address |
100 Mario Capecchi Dr Salt Lake City UT 84113-1103 |
| Practice Telephone | 8012854000 |
| Mailing Telephone | 8016625696 |
| Mailing Fax Number | 8016625699 |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2010-07-08 |
| Authorized Official Name | DR. EDWARD B CLARK (CHAIRMAN) |
| Authorized Official Telephone | 8015877400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
48547254405 | UT | Ambulatory Health Care Facilities |
| Street Address |
3741 W 12600 S |
| City | RIVERTON |
| State | UT |
| Zip Code | 84065-7215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982647145 | Daniel Louis Chadwell | Audiologist | 3741 W 12600 S, Intermountain Riverton Hospital, Riverton, UT 84065-7215 | 2006-06-14 |
| 1023619533 | Carson Chandler | Physical Therapist | 3741 W 12600 S, Riverton, UT 84065-7215 | 2020-11-03 |
| 1245885664 | Jessica Marie Roestenburg | Occupational Therapist | 3741 W 12600 S, Riverton, UT 84065 | 2019-08-02 |
| 1366902306 | Megan Nalder | Speech-Language Pathologist | 3741 W 12600 S, Riverton, UT 84065-7215 | 2019-03-25 |
| 1205367836 | Jessica Posch | Speech-Language Pathologist | 3741 W 12600 S, Riverton, UT 84065-7215 | 2017-03-24 |
| 1013465921 | Cambry Kaylor | Occupational Therapist | 3741 W 12600 S, Riverton, UT 84065-7215 | 2016-09-20 |
| 1952752008 | Shelly Hardy | Physical Therapist | 3741 W 12600 S, Riverton, UT 84065-7215 | 2016-06-29 |
| 1114378288 | Intermountain Healthcare | Clinic/Center | 3741 W 12600 S, Riverton, UT 84065-7215 | 2016-06-29 |
| 1508215807 | Jordan Wood | Physical Therapist | 3741 W 12600 S, Riverton, UT 84065-7215 | 2016-06-07 |
| 1376907410 | University of Utah Pediatric Acuity Care | Pediatrics | 3741 W 12600 S, Riverton, UT 84065-7215 | 2016-04-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972248 | William Lance Andersen | Pharmacist | 1202 W 12600 W, Riverton, UT 84065 | 2020-11-02 |
| 1275172678 | Dentists of Riverton, LLP | Dentist | 4531 W. Partridgehill Lane, Suite F-110, Riverton, UT 84065 | 2020-01-02 |
| 1194201467 | Patrick Kunkel | Dentist | 12569 2700 W, #100, Riverton, UT 84065 | 2018-07-19 |
| 1790274546 | Harmon City Inc | Pharmacy | 13330 South Kestrel Range Road, Riverton, UT 84065 | 2018-05-08 |
| 1386147767 | Richard Hayes Johnston | Counselor | 3740 S Market Center Dr #1200, Riverton, UT 84065 | 2018-03-13 |
| 1023537156 | Brenda Fuell | Dental Hygienist | 12959 South Picket Fence Lane, Riverton, UT 84065 | 2017-09-09 |
| 1407373426 | Bethany Marie Breck | Counselor | 3740 S Market Center Drive, #1200, Riverton, UT 84065 | 2017-08-30 |
| 1952848509 | Renaissance Ranch Bluffdale Women's Program | Substance Abuse Rehabilitation Facility | 2356 Thunderhead Way, Bluffdale, UT 84065 | 2017-01-20 |
| 1053856229 | Bradford Scott Bentley Jr. | Physical Therapist | 3741 W 12600 S, Ste 100, Riverton, UT 84065 | 2016-12-27 |
| 1194273524 | New Horizon | Preferred Provider Organization | 1420 W 12600 Sputh, Draper, UT 84065 | 2016-09-14 |
| Find all providers in zip 84065 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1427288281 | Ihc Health Services Inc | Clinic/Center | 3741 West 12600 South, Riverton, UT 84065-0000 | 2009-07-15 |
| 1841514668 | Ihc Health Services Inc | Clinic/Center | 3741 W 12600 S, Riverton, UT 84065-7215 | 2010-03-23 |
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| 1750928214 | Kyunghee Seo K Mental Health Clinic | Clinic/Center | 1160 S State St Ste 160a, Orem, UT 84097-8263 | 2019-12-04 |
| 1740836345 | The Lift Clinic, LLC | Clinic/Center | 345 W 100 S # 6c, Slc, UT 84101-1209 | 2019-08-11 |
| 1952953101 | Restorative Health Primary Care | Clinic/Center | 850 E 9400 S Ste 101, Sandy, UT 84094-4114 | 2019-07-09 |
| 1063986800 | Healthworks Med Group of Utah P C | Clinic/Center | 4163 S 3200 W, West Valley City, UT 84119-5128 | 2019-01-15 |
| 1235615790 | Community Birth Group | Clinic/Center | 1190 E 5425 S Ste 330, South Ogden, UT 84403-4548 | 2018-07-17 |
| 1275044075 | Edge Medical Services Inc. | Clinic/Center | 959 W Sedge Ct, Farmington, UT 84025-2541 | 2017-10-19 |
| 1992214027 | National Birth Centers, Inc | Clinic/Center | 4345 S Vallejo Dr, Holladay, UT 84124-3756 | 2017-09-20 |
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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.