JOHN CARLOS GONZALES (NPI# 1699278366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699278366 |
| Entity Type | Individual |
| Full Name | JOHN CARLOS GONZALES |
| Practice Address |
7873 S Chadbourne Dr Cottonwood Heights UT 84121-5806 |
| Practice Telephone | 8012443280 |
| Mailing Telephone | 8012443280 |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2018-03-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | BLUE CROSS BLUE SHIELD | R58639857 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508153826 | John David Gonzales | Chiropractor | 9960 Business Park Dr 140, Sacramento, CA 95827-1719 | 2011-07-07 |
| 1477679876 | John Phillip Gonzales | Dentist | 311 N Mandan St, Bismarck, ND 58501-3859 | 2007-03-21 |
| 1447207402 | John Michael Gonzales | Pathology | 100-c Albright Way, San Jose, CA 95032-1837 | 2006-05-27 |
| 1639655723 | John Mejia Gonzales II | Counselor | 2005 Ashland Ave, Toledo, OH 43620-1703 | 2018-07-12 |
| 1730433467 | John Gonzales | Counselor | 1218 Griegos Rd Nw, Albuquerque, NM 87107-3752 | 2012-11-02 |
| 1821363102 | John Ray Gonzales | Anesthesiology | 1229 Madison St Ste 1440, Seattle, WA 98104-3538 | 2012-03-20 |
| 1184911125 | John Paul Gonzales | Case Manager/Care Coordinator | 906 N 1st St, Grants, NM 87020-2806 | 2011-06-28 |
| 1578861712 | John Gonzales Iv | Hearing Instrument Specialist | 1902 W 19th St, Suite A, Mountain Grove, MO 65711-1287 | 2011-03-12 |
| 1376785469 | John Daniel Gonzales Jr. | Nurse Anesthetist, Certified Registered | 2435 Forest Dr, Columbia, SC 29204-2026 | 2009-04-03 |
| 1881852366 | John Alexander Gonzales | Ophthalmology | 3332 Rochambeau Ave, Third Floor, Bronx, NY 10467-2836 | 2008-05-30 |
| Street Address |
7873 S CHADBOURNE DR |
| City | COTTONWOOD HEIGHTS |
| State | UT |
| Zip Code | 84121-5806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407483522 | Kaitlyn Horne | Behavior Technician | 6910 S. Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-26 |
| 1952936387 | Jared Wells | Behavior Technician | 6910 S Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-05 |
| 1518591874 | Slc Plastic Surgery LLC | Plastic Surgery | 6686 Highland Drive, Cottonwood Heights, UT 84121 | 2020-02-26 |
| 1093273708 | Anna O'hearon | Counselor | New Roads Behavioral Health, 2450 Fort Union Blvd, Cottonwood Heights, UT 84121 | 2019-03-12 |
| 1053883181 | Charles Keller IIi | Pediatrics | 2198 S Yvonne Rd #344, Salt Lake City, UT 84121 | 2018-12-31 |
| 1669964516 | Marissa King | Specialist | 1141 E. 3900 S. Suite 150a, Salt Lake, UT 84121 | 2018-06-05 |
| 1376044313 | Slpd Cottonwood LLC | Dentist | 7167 South Highland Drive, 200, Cottonwood Heights, UT 84121 | 2018-02-26 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1912430588 | Wasatch Midwifery and Wellness, LLC | Dietitian, Registered | 6440 S Wasatch Blvd, Ste 140, Holladay, UT 84121 | 2017-04-10 |
| 1407308331 | Tina Polgar | Registered Nurse | 6244 Highland Drive, Murray, UT 84121 | 2016-10-26 |
| Find all providers in zip 84121 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043819600 | Devin J Morrison | Peer Specialist | 230 W 200 S Unit 142, Salt Lake City, UT 84110-6006 | 2020-10-23 |
| 1104423532 | Chante Colvin | Peer Specialist | 3638 Sugar Leo Rd, St George, UT 84790-7452 | 2020-10-08 |
| 1518579077 | Henry Matthews | Peer Specialist | 474 N Grant St, Salt Lake City, UT 84116-2726 | 2020-08-17 |
| 1508497892 | Jamie Len Griffin | Peer Specialist | 256 W 100 S, Logan, UT 84321-5231 | 2020-01-27 |
| 1295370013 | Amber Chandler | Peer Specialist | 15257 S Scenic Crest Cir, Bluffdale, UT 84065-5076 | 2019-11-15 |
| 1780232272 | Billie Jo Burnett | Peer Specialist | 1429 N 1200 W, Orem, UT 84057-2449 | 2019-08-28 |
| 1669025227 | Ryan Ballard | Peer Specialist | 589 E 8680 S, Sandy, UT 84070-1779 | 2019-07-22 |
| 1134780042 | Michael James Olsen | Peer Specialist | 344 E 100 S Ste 301300, Salt Lake City, UT 84111-1700 | 2019-06-23 |
| 1659836393 | Brittney Emi Vaovasa | Peer Specialist | 252 W Brooklyn Ave, Salt Lake City, UT 84101-3024 | 2019-02-06 |
| 1306348263 | Kurt Kyle Landenberger | Peer Specialist | 2200 S State St Fl 2, Salt Lake City, UT 84115-2724 | 2018-03-06 |
| Find all providers with the same taxonomy | ||||
| City | COTTONWOOD HEIGHTS |
| Zip Code | 84121 |
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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.