FLEGAL FOOT & ANKLE CLINIC, LLC (NPI# 1710955745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710955745 |
| Entity Type | Organization |
| Organization Name | FLEGAL FOOT & ANKLE CLINIC, LLC |
| Other Organization Name | FLEGAL CLINIC, LLC |
| Practice Address |
740 E 3900 S Suite 108 Salt Lake City UT 84107-2525 |
| Practice Telephone | 8012663113 |
| Mailing Telephone | 8012663113 |
| Mailing Fax Number | 8012665633 |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2012-08-28 |
| Authorized Official Name | DR. DOUGLAS CLARK FLEGAL (MANAGER) |
| Authorized Official Telephone | 8012663113 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
102232-0501 | UT | Podiatric Medicine & Surgery Service Providers |
| Other Name | Type Code |
|---|---|
| Flegal Clinic, LLC | Doing Business As Name - Organization |
| Street Address |
740 E 3900 S SUITE 108 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84107-2525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679847461 | Lyndsi Parker | Social Worker | 740 E 3900 S, Suite 200, Salt Lake City, UT 84107-2181 | 2012-02-27 |
| 1174806871 | Sara Elizabeth Nassof | Social Worker | 740 E 3900 S, Suite #200, Salt Lake City, UT 84107-2181 | 2011-09-20 |
| 1356637409 | Taylor G Wright | Podiatrist | 740 E 3900 S, #108, Salt Lake City, UT 84107-2181 | 2011-06-27 |
| 1972896702 | Charles Johnson | Social Worker | 740 E 3900 S, # 100, Salt Lake City, UT 84107-2181 | 2011-05-26 |
| 1902195308 | Lauren Michelle Stivers | Social Worker | 740 E 3900 S, Salt Lake City, UT 84107-2181 | 2011-04-06 |
| 1336452481 | Lifematters Counseling & Health Center | Nurse Practitioner | 740 E 3900 S, #100, Salt Lake City, UT 84107-2181 | 2010-07-19 |
| 1063741577 | Patrick Joseph Gooley | Social Worker | 740 E 3900 S, Suite 100, Salt Lake City, UT 84107-2181 | 2009-12-11 |
| 1063680668 | Douglas Clark Flegal | Podiatrist | 740 E 3900 S, Suite 108, Salt Lake City, UT 84107-2181 | 2008-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| 1972875524 | Utah Podiatry Group PC | Podiatrist | 2159 S 700 E Ste 150, Salt Lake City, UT 84106 | 2012-01-29 |
| 1891082830 | Selina Sekulic | Podiatrist | 348 E 4500 S Ste 370, Salt Lake City, UT 84107-3906 | 2011-06-28 |
| 1841586096 | Brian B Liljenquist | Podiatrist | 1250 E 3900 S Ste 440, Salt Lake City, UT 84124 | 2011-06-27 |
| 1659683381 | Christiaan Horst Goebel | Podiatrist | 4578 S Highland Dr, Suite 380, Salt Lake City, UT 84117-4243 | 2010-07-10 |
| 1639306889 | Daniel L Preece | Podiatrist | 430 N 400 W, Salt Lake City, UT 84103-1229 | 2009-06-15 |
| 1962513820 | Jason Ross Bowen | Podiatrist | 3710 Twinbrook St, Salt Lake City, UT 84109-3714 | 2006-08-31 |
| 1760499180 | Paul Norman Daniels | Podiatrist | 1449 E 3300 S, Salt Lake City, UT 84106-3308 | 2006-08-01 |
| 1700865748 | Scott A Clark | Podiatrist | 24 S 1100 E Ste 210, Salt Lake City, UT 84102 | 2006-01-10 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84107 |
Please comment or provide details below to improve the information on FLEGAL FOOT & ANKLE CLINIC, LLC.
| 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.