LAKEVIEW NEUROSURGERY CLINIC, LLC (NPI# 1831202118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831202118 |
| Entity Type | Organization |
| Organization Name | LAKEVIEW NEUROSURGERY CLINIC, LLC |
| Practice Address |
620 Medical Dr Suite 300 Bountiful UT 84010-5084 |
| Practice Telephone | 8012993871 |
| Mailing Telephone | 8012993871 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JEFF RYDBURG (VP) |
| Authorized Official Telephone | 8012993871 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619919396 | Lakeview Neurosurgery Clinic, LLC | Neurological Surgery | 620 Medical Dr, Suite 300, Bountiful, UT 84010-4908 | 2006-06-10 |
| Street Address |
620 MEDICAL DR SUITE 300 |
| City | BOUNTIFUL |
| State | UT |
| Zip Code | 84010-5084 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942294475 | Molly Mears | Obstetrics & Gynecology | 620 Medical Dr, Suite 340, Bountiful, UT 84010-4908 | 2005-09-12 |
| 1083156384 | Melissa Yamashiro | Physician Assistant | 620 Medical Dr, Suite 205, Bountiful, UT 84010-5084 | 2016-11-17 |
| 1114217205 | Andrea P Edwards | Pediatrics | 620 Medical Dr, Suite 100, Bountiful, UT 84010-5084 | 2011-04-11 |
| 1861676165 | Lakeview Neurology PC | Neurological Surgery | 620 Medical Dr, Suite 150, Bountiful, UT 84010-5084 | 2007-12-21 |
| 1205977188 | Jonathan Milton Tew | Pediatrics | 620 Medical Dr, Suite 100, Bountiful, UT 84010-5084 | 2007-02-12 |
| 1598831604 | Laura Maudlyn Zaugg | Advanced Practice Midwife | 620 Medical Dr, Suite 340, Bountiful, UT 84010-5084 | 2006-11-28 |
| 1548360217 | Cope Family Medicine Lc | Family Medicine | 620 Medical Dr, Suite 150, Bountiful, UT 84010-5084 | 2006-09-23 |
| 1194825117 | Gina M Muscolino | Specialist | 620 Medical Dr, Suite 340, Bountiful, UT 84010-5084 | 2006-09-22 |
| 1932112448 | Lakeview Hospital Physician Services LLC | Obstetrics & Gynecology | 620 Medical Dr, Suite 340, Bountiful, UT 84010-5084 | 2006-08-14 |
| 1376568352 | Pamela J. Hildebrand | Pediatrics | 620 Medical Dr, #100, Bountiful, UT 84010-5084 | 2006-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225699192 | Jessyca K Willie | Behavior Technician | 415 S. Medical Drive Suite D101, Bountiful, UT 84010 | 2019-06-21 |
| 1336634344 | Shanna Joy Jaggers | Social Worker | 2333 S 200 E, Bountiful, UT 84010 | 2018-06-22 |
| 1447773171 | Live Life Alarms | Emergency Response System Companies | 640 South 500 West, Bountiful, UT 84010 | 2017-07-25 |
| 1902328842 | Hailey Embley | Behavior Technician | 415 Medical Drive D 101, Bountiful, UT 84010 | 2017-07-12 |
| 1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
| 1295287720 | Samantha Oslund | Speech-Language Pathologist | 415 Medical Dr Ste B102, Bountiful, UT 84010 | 2016-11-01 |
| 1750748273 | Jeremy Clark Morris | Dentist | 59 W 1600 N, Suite 110, Bountiful, UT 84010 | 2016-01-28 |
| 1629464706 | Shane James | Speech-Language Pathologist | 425 Medical Dr Ste 122, Bountiful, UT 84010 | 2015-04-15 |
| 1891186102 | Kenton Francis | Social Worker | 1355 North Main Street #1, Bountiful, UT 84010 | 2015-02-09 |
| 1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
| Find all providers in zip 84010 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164410403 | Mohamed Habibulla Sadiq | Psychiatry & Neurology | 620 East Medical Drive, Suite 150, Bountiful, UT 84010-5085 | 2005-10-11 |
| 1174868525 | Mountainstar Behavioral Health LLC | Psychiatry & Neurology | 630 Medical Dr, Bountiful, UT 84010-4908 | 2012-12-11 |
| 1740508340 | Heidee Lynn Lund | Psychiatry & Neurology | 630 Medical Dr, Bountiful, UT 84010-4908 | 2010-05-07 |
| 1417923251 | Austin Blair Imus | Psychiatry & Neurology | 630 Medical Dr, Bountiful, UT 84010-4908 | 2006-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607589 | Trenton L Overall, Inc | Psychiatry & Neurology | 295 S 1470 E Ste 301, St George, UT 84790-1762 | 2020-10-23 |
| 1720648744 | Carepoint Health, LLC | Psychiatry & Neurology | St. Mark's Hospital, 1200 E 3900 S, Salt Lake City, UT 84124-1300 | 2019-06-20 |
| 1629596382 | Red Rock Neurology, LLC | Psychiatry & Neurology | 515 S 300 E Ste 107, St George, UT 84770-3931 | 2017-09-01 |
| 1225482276 | Preston Erickson | Psychiatry & Neurology | 4403 Harrison Blvd Ste 3855, Ogden, UT 84403-3349 | 2016-04-15 |
| 1801273743 | Michael Cline | Psychiatry & Neurology | 825 E 1700 S, Salt Lake City, UT 84105-3225 | 2015-04-29 |
| 1619219847 | Mark Waheed | Psychiatry & Neurology | The University of Utah, 50 North Medical Drive, Salt Lake City, UT 84132-0001 | 2013-03-26 |
| 1568707586 | Kyle Mahoney | Psychiatry & Neurology | 175 N Medical Drive E 3rd Floor, Salt Lake City, UT 84132 | 2012-12-03 |
| 1538435979 | Brett Tyson Alldredge | Psychiatry & Neurology | 4403 Harrison Blvd # 4403, Ogden, UT 84403-3271 | 2012-03-29 |
| 1922377043 | Southern Utah Neuropsychiatry | Psychiatry & Neurology | 577 East Tabernacle, St. George, UT 84770-2944 | 2011-12-19 |
| 1699076224 | Angela Yvonne Peters | Psychiatry & Neurology | University of Utah Dept of Neurology, 175 N Medical Drive East, Salt Lake City, UT 84132-0001 | 2010-11-12 |
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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.