CEDAR CREEK FAMILY HEALTH CARE LLC (NPI# 1639323280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639323280 |
| Entity Type | Organization |
| Organization Name | CEDAR CREEK FAMILY HEALTH CARE LLC |
| Other Organization Name | MAJESTIC OAKS FAMILY HEALTH CARE |
| Practice Address |
453 N Main St Ste A Tooele UT 84074-1654 |
| Mailing Address |
14540 Majestic Oaks Ln Herriman UT 84096-3645 |
| Practice Telephone | 8012321998 |
| Mailing Telephone | 8012321998 |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2010-04-02 |
| Authorized Official Name | LU ANN JACOBS-PETERSON (FNP) |
| Authorized Official Telephone | 8012321998 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 219855-8900 | UT | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Majestic Oaks Family Health Care | Former Legal Business Name - Organization |
| Street Address |
453 N MAIN ST STE A |
| City | TOOELE |
| State | UT |
| Zip Code | 84074-1654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689233397 | Leah Elizabeth Harper I | Behavior Technician | 39 Millpond Stansbury Park, Tooele, UT 84074 | 2019-06-07 |
| 1245710789 | Tanna Marie Shelley | Community Health Worker | 27 So Main St, Tooele, UT 84074 | 2018-08-15 |
| 1528548062 | Barbara T Cederlof | Community Health Worker | 27 South Main St., Tooele, UT 84074 | 2018-08-15 |
| 1235615600 | Ashley Christine Wilson | Case Manager/Care Coordinator | 27 South Main, Tooele, UT 84074 | 2018-07-18 |
| 1174016976 | Makenzie Green | Case Manager/Care Coordinator | 27 S Main, Tooele, UT 84074 | 2018-06-07 |
| 1386151835 | Monica Lee | Physical Therapist | 6727 Ut-36 #300, Stansbury Park, UT 84074 | 2018-01-05 |
| 1871976183 | Pagnani Physical Therapy | Physical Therapist | 6727 North State Hwy 36, Suite 300, Stansbury Park, UT 84074 | 2015-07-06 |
| 1407248222 | Pebble Creek Counseling Center | Counselor | 494 E 2400 N Ste B, Tooele, UT 84074 | 2015-03-03 |
| 1528496221 | Emily Carlson | Case Manager/Care Coordinator | 220 North Millpond Rd, Suite 100, Stansbury Park, UT 84074 | 2013-10-16 |
| 1710327218 | Angela Michelle Demoss | Nurse Practitioner | 682 Country Club, Stansbury Park, UT 84074 | 2013-06-28 |
| Find all providers in zip 84074 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710468384 | Skull Valley Health Clinic | Clinic/Center | 1929 Aaron Dr Ste I, Tooele, UT 84074-8112 | 2018-08-22 |
| 1699813733 | Associates for Inpatient Medicine | Clinic/Center | 196 E 2000 N Ste 107, Tooele, UT 84074-9335 | 2007-02-01 |
| 1366719015 | Jim J. Gould, Md PC | Clinic/Center | 2356 N 400 E, Suite 202, Tooele, UT 84074-3409 | 2011-11-23 |
| 1043448798 | Spine and Posture Rehabilitation of Tooele | Clinic/Center | 300 S Main St, Suite 2, Tooele, UT 84074-2766 | 2009-07-01 |
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| 1578100186 | 124 South Fairfield LLC | Clinic/Center | 124 S Fairfield Rd Ste B, Layton, UT 84041-7106 | 2019-12-02 |
| 1275021784 | Axis Chiropractic and Massage Clinic, LLC | Clinic/Center | 1681 W 3860 S Ste 106, West Valley City, UT 84119-6274 | 2018-04-30 |
| 1760979397 | Moenkopi Counseling PC | Clinic/Center | 230 N 1680 E Ste H2, Saint George, UT 84790-2585 | 2018-04-19 |
| 1669978896 | Southern Utah Vision Care Pllc | Clinic/Center | 1251 Northfield Rd Ste 215, Cedar City, UT 84721-8623 | 2018-04-05 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1992212641 | Ideal Option, Pllc | Clinic/Center | 2230 N University Pkwy Ste 5, Provo, UT 84604-4743 | 2018-01-03 |
| 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.