INTERMOUNTAIN SPINE PARTNERS (NPI# 1821458878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821458878 |
| Entity Type | Organization |
| Organization Name | INTERMOUNTAIN SPINE PARTNERS |
| Other Organization Name | INTERMOUNTAIN SPINE INSTITUTE |
| Practice Address |
5770 South 250 East Suite 135 Salt Lake City UT 84107-8241 |
| Practice Telephone | 8013142225 |
| Practice Fax Number | 8013142345 |
| Mailing Telephone | 8013142225 |
| Mailing Fax Number | 8013142345 |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2016-03-03 |
| Authorized Official Name | REED EUGENE FOGG (DIRECTOR) |
| Authorized Official Telephone | 8013142225 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Intermountain Spine Institute | Doing Business As Name - Organization |
| Street Address |
5770 SOUTH 250 EAST SUITE 135 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84107-8241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881663870 | Reed Fogg | Orthopaedic Surgery | 5770 South 250 East, Suite 135, Salt Lake City, UT 84107-8241 | 2006-03-14 |
| 1639371149 | Justin B Hohl | Orthopaedic Surgery | 5770 South 250 East, Suite 135, Salt Lake City, UT 84107-8241 | 2007-06-05 |
| 1427018761 | Junius Clawson | Orthopaedic Surgery | 5770 South 250 East, Suite 135, Salt Lake City, UT 84107-8241 | 2006-03-23 |
| 1922068212 | James Bradley Davis | Physician Assistant | 5770 South 250 East, Suite 135, Salt Lake City, UT 84107-8241 | 2006-03-23 |
| 1164481008 | Terry Sawchuk | Physical Medicine & Rehabilitation | 5770 South 250 East, Suite 135, Salt Lake City, UT 84107-8241 | 2006-03-20 |
| 1982673505 | Robert Berry | Orthopaedic Surgery | 5770 South 250 East, Suite 135, Salt Lake City, UT 84107-8241 | 2006-03-16 |
| 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 | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477081412 | Alta Canyon Spine LLC | Orthopaedic Surgery | 5770 S 250 E Ste 135, Salt Lake City, UT 84107-8241 | 2017-06-02 |
| 1881663870 | Reed Fogg | Orthopaedic Surgery | 5770 South 250 East, Suite 135, Salt Lake City, UT 84107-8241 | 2006-03-14 |
| 1841654407 | University of Utah Pediatric Services | Orthopaedic Surgery | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-04-11 |
| 1770987471 | University of Utah Surgical Services | Orthopaedic Surgery | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2014-10-09 |
| 1902223043 | Peter Shorten | Orthopaedic Surgery | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2014-03-26 |
| 1114978533 | Richard Andrew Dal Canto | Orthopaedic Surgery | 389 S 900 E, Salt Lake City, UT 84102-2310 | 2006-05-12 |
| 1982673505 | Robert Berry | Orthopaedic Surgery | 5770 South 250 East, Suite 135, Salt Lake City, UT 84107-8241 | 2006-03-16 |
| 1730171232 | Kade T Huntsman | Orthopaedic Surgery | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2005-08-19 |
| 1851383350 | Brent A Felix | Orthopaedic Surgery | 1160 E 3900 S Ste 4050, Salt Lake City, UT 84124-1264 | 2005-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972741528 | Stephen J. Warner Md PC | Orthopaedic Surgery | 5323 South Woodrow Street Suite 200, Murray, UT 84107 | 2009-02-04 |
| 1518115419 | Reed Fogg Md PC | Orthopaedic Surgery | 5770 So 250 E, Suite 135, Murray, UT 84107-8241 | 2008-09-04 |
| 1164491460 | Stephen M Hansen | Orthopaedic Surgery | 619s Bluff St, St George, UT 84770-3853 | 2006-03-17 |
| 1457793697 | Huntsman West Spine LLC | Orthopaedic Surgery | 230 N 1680 E, Ste I-1, Saint George, UT 84790-2579 | 2013-07-29 |
| 1295755924 | Gary D Snook | Orthopaedic Surgery | 2321 N 400 E Ste 300, Tooele, UT 84074-3440 | 2006-07-19 |
| 1164453106 | Stephen Warner | Orthopaedic Surgery | 5323 South Woodrow Street, Suite 200, Murray, UT 84107 | 2006-07-06 |
| 1801879226 | Alpine Management and Consulting | Orthopaedic Surgery | 1030 Medical Dr Ste A, Brigham City, UT 84302-3276 | 2005-11-21 |
| City | SALT LAKE CITY |
| Zip Code | 84107 |
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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.