UTAH ADDICTION MEDICINE


Address: 619 N 500 W, Provo, UT 84601-1547
Phone: 8018529440

UTAH ADDICTION MEDICINE (NPI# 1598267122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598267122
Entity Type Organization
Organization Name UTAH ADDICTION MEDICINE
Practice Address 619 N 500 W
Provo
UT 84601-1547
Practice Telephone 8018529440
Mailing Telephone 8018529440
Enumeration Date 2018-02-28
Last Update Date 2018-03-17
Authorized Official Name ROBERT SIMPSON (OWNER)
Authorized Official Telephone 8018529440
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QA0401X Family Medicine
Specialization: Addiction Medicine
Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
1377 E 3900 S Ste 200, Salt Lake City, UT 841241496 8018529440

Office Location

Street Address 619 N 500 W
City PROVO
State UT
Zip Code 84601-1547

Providers in the same location

NPI Name Taxonomy Address Enumeration
1417977505 Susan R Dyle Physician Assistant 619 N 500 W, Provo, UT 84601-1547 2006-07-20
1902430531 Brighter Path Addiction Medicine Obstetrics & Gynecology 619 N 500 W, Provo, UT 84601-1547 2020-02-21
1306387105 Brenton Lisonbee Counselor 619 N 500 W, Provo, UT 84601-1547 2017-03-13
1114469921 Janessa Rasmussen Community Health Worker 619 N 500 W, Provo, UT 84601-1547 2016-11-09
1750823563 Camille Brown Community Health Worker 619 N 500 W, Provo, UT 84601-1547 2016-11-09
1922540731 Keiyana Osmond Community Health Worker 619 N 500 W, Provo, UT 84601-1547 2016-11-09
1003358813 Haley Allmendinger Community Health Worker 619 N 500 W, Provo, UT 84601-1547 2016-11-09
1740648898 Alexis Zimmerman Counselor 619 N 500 W, Provo, UT 84601-1547 2016-02-04
1245697978 Carlos Ensaldo Counselor 619 N 500 W, Provo, UT 84601-1547 2016-01-26
1962869933 Kayla Nymeyer Counselor 619 N 500 W, Provo, UT 84601-1547 2016-01-21
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902378417 1 Assist Care of Utah Valley LLC In Home Supportive Care 180 N University Avenue, Suite 270, Office 213, Provo, UT 84601 2018-12-21
1346723319 Mp Dental LLC Dentist 777 N. 500 W. #204, Proud, UT 84601 2018-09-14
1326530601 Madison Paige Nelson Case Manager/Care Coordinator 750 N Freedom Blvd., Provo, UT 84601 2018-06-03
1245758861 Annette Roylance Case Manager/Care Coordinator 750 North Freedom Boulevard, Suite 300, Provo, UT 84601 2017-09-04
1912422205 Alexandra Mcbride Specialist/Technologist 35 N 300 W #440, Provo, UT 84601 2017-08-07
1932638293 Audrey Clara Clifton Case Manager/Care Coordinator 750 North Freedom Blvd., Provo, UT 84601 2017-06-08
1528514197 Joseph Hyrum Lewis Case Manager/Care Coordinator 750 Freedom Blvd, Provo, UT 84601 2016-09-01
1629427620 Walker Clements Case Manager/Care Coordinator 750 North Freedom Blvd, Provo, UT 84601 2016-06-09
1447611595 Robert Shirley Student in an Organized Health Care Education/Training Program 750 North 200 West, Provo, Ut 84601., Provo, UT 84601 2016-03-17
1700286283 Brelynn Downs Student in an Organized Health Care Education/Training Program 750 North Freedom Blvde, Provo, UT 84601 2014-09-03
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Taxonomy Information

Taxonomy Code 207QA0401X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Addiction Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1538114889 Daniel Clyde Cummings Family Medicine 694 N 1890 W Unit 44a, Provo, UT 84601-1327 2006-05-24
1730554734 Blue Rock Neurological LLC Family Medicine 3152 N University Ave Ste 220, Provo, UT 84604-4746 2015-12-02
1285829309 Lawrence W. Astle Family Medicine 151 S University Ave, Suite 1400, Provo, UT 84601-4427 2007-09-11

Providers in the same taxonomy and state

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
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
1689037566 Salt Lake Behavioral Health, LLC Family Medicine 3802 S 700 E, Salt Lake City, UT 84106-1182 2016-03-30
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Competitor

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City PROVO
Zip Code 84601

Improve Information

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Dataset Information

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.

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