SOUTH SUMMIT PEDIATRICS. LLC (NPI# 1760490122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760490122 |
| Entity Type | Organization |
| Organization Name | SOUTH SUMMIT PEDIATRICS. LLC |
| Practice Address |
267 E Traversepoint Drive Draper UT 84020 |
| Practice Telephone | 8015679780 |
| Practice Fax Number | 8015679826 |
| Mailing Telephone | 8015679780 |
| Mailing Fax Number | 8015679826 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2007-11-13 |
| Authorized Official Name | DR. PAUL S LEI (OWNER) |
| Authorized Official Telephone | 8015679780 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 173000000X | Legal Medicine | 363788-1205 | UT | Other Service Providers |
| Street Address |
267 E TRAVERSEPOINT DRIVE |
| City | DRAPER |
| State | UT |
| Zip Code | 84020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
| 1780222380 | Derek Cragun | Counselor | 11706 700 E, Draper, UT 84020 | 2019-12-13 |
| 1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
| 1508418856 | Thomas Mifflin | Physician Assistant | 721 East 12200 South, Draper, UT 84020 | 2019-07-16 |
| 1124670872 | Necia Dalley | Registered Nurse | 11800 S State St, Draper, UT 84020 | 2019-07-12 |
| 1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
| 1275008328 | Amoni Paeahelotu Finau | Community Health Worker | 13703 Wheatfield Way, Draper, UT 84020 | 2018-10-04 |
| 1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
| 1164908026 | Headin' Home Inc. | Community/Behavioral Health | 12300 S. 150 W., Draper, UT 84020 | 2018-07-13 |
| 1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
| Find all providers in zip 84020 | ||||
| Taxonomy Code | 173000000X |
| Grouping | Other Service Providers |
| Classification | Legal Medicine |
| The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508305566 | Gracelyn Estrada | Legal Medicine | 955 S 225 E, Layton, UT 84041-4169 | 2017-02-22 |
| 1235391327 | David L. Wilkerson | Legal Medicine | 2856 Snow Cir, St George, UT 84790-7650 | 2008-06-30 |
| 1487716031 | Crossroads Family Medicine | Legal Medicine | 1305 N Commerce Dr Ste 120, Saratoga Springs, UT 84043-5309 | 2006-12-13 |
| 1871502567 | Henry Klein | Legal Medicine | 3556 W 9800 S Ste 101, South Jordan, UT 84095-3221 | 2006-08-05 |
| 1215964309 | Randal John Lewis | Legal Medicine | 310 E 4500 S Ste 410, Murray, UT 84107-3993 | 2006-06-26 |
| 1548208028 | William Pidwell | Legal Medicine | 750 Round Valley Dr., Suite 201, Park City, UT 84060-5127 | 2006-06-04 |
| 1669452298 | Custom Medical Services | Legal Medicine | Rr 3 Box 3053, Roosevelt, UT 84066-9609 | 2006-01-19 |
| 1033111810 | Andrew Gerald Smith | Legal Medicine | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2005-08-11 |
| 1710152228 | Brent J. Bowen, M.d.p.c. | Legal Medicine | 5250 Commerce Dr, Suite 200, Salt Lake City, UT 84107-7926 | 2008-04-25 |
| 1508067950 | Park City Healthcare, PC | Legal Medicine | 1665 Bonanza Drive, Park City, UT 84060 | 2007-05-31 |
| 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.