ASHLEY VALLEY PHYSICIAN PRACTICE LLC (NPI# 1871834960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871834960 |
| Entity Type | Organization |
| Organization Name | ASHLEY VALLEY PHYSICIAN PRACTICE LLC |
| Other Organization Name | ROOSEVELT COMMUNITY CLINIC |
| Practice Address |
409 S 200 E Roosevelt UT 84066-3314 |
| Practice Telephone | 4357810757 |
| Practice Fax Number | 4357812628 |
| Mailing Telephone | 4357810757 |
| Mailing Fax Number | 4357812628 |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2013-04-15 |
| Authorized Official Name | JESS N JUDY (PRESIDENT) |
| Authorized Official Telephone | 6153728500 |
| Is Organization Subpart | Y |
| Parent Organization Name | ASHLEY VALLEY PHYSICIAN PRACTICE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| ROOSEVELT COMMUNITY CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164937645 | Ashley Valley Physician Practice LLC | Obstetrics & Gynecology | 150 W 100 N, Vernal, UT 84078-2036 | 2017-12-06 |
| 1255568564 | Ashley Valley Physician Practice LLC | Orthopaedic Surgery | 175 N 100 W, Suite 204, Vernal, UT 84078-2049 | 2009-06-12 |
| Street Address |
409 S 200 E |
| City | ROOSEVELT |
| State | UT |
| Zip Code | 84066-3314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518247709 | Ashley Valley Physician Practice, LLC | Family Medicine | 409 S 200 E, Roosevelt, UT 84066-3314 | 2011-08-19 |
| 1013297142 | Sarah Heaton | Physician Assistant | 409 S 200 E, Roosevelt, UT 84066-3314 | 2011-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477075315 | Annemarie Rousseau | Registered Nurse | 250 West 300 North, Roosevelt, UT 84066 | 2017-07-12 |
| 1780036772 | Drew Gilley | Dentist | 375 E Lagoon St, Roosevelt, Ut 84066, Roosevelt, UT 84066 | 2016-07-01 |
| 1952758039 | Amanda Adams | Massage Therapist | 1151 East Hwy 40, Ballard, UT 84066 | 2016-05-19 |
| 1447624325 | Gregory George Page | Dentist | 209 West 200 North 71-2, Roosevelt, UT 84066 | 2015-11-16 |
| 1659785772 | Becky Ann Birch | Nurse Practitioner | 200 West 350 North, Ste 103, Roosevelt, UT 84066 | 2014-06-17 |
| 1760724280 | Novo Ranch LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3549 W 1000 North, Roosevelt, UT 84066 | 2013-03-22 |
| 1508110040 | Uintah Basin Spine and Disc Center, PC | Rehabilitation Unit | 1151 East Highway 40, Roosevelt, UT 84066 | 2012-11-06 |
| 1184918682 | Alvaro Beltran | Dentist | Ave. Lopez Mateos 171-4, Nogales, SONORA 84066 | 2011-06-02 |
| 1255638367 | Cosme Cantu | Dentist | Blvd. El Greco #45 Int. J-14, Nogales, SONORA 84066 | 2011-02-25 |
| 1740482009 | Northeastern Utah Medical Group | Durable Medical Equipment & Medical Supplies | 210 W 300 N 75 3, Roosevelt, UT 84066 | 2007-05-31 |
| Find all providers in zip 84066 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992980866 | Donald Wain Allen | Clinic/Center | 228 West 200 South, Suite 2, Kamas, UT 84036-0159 | 2008-01-09 |
| 1558558627 | Robert L Smith Dc PC | Clinic/Center | 55 E Center St, Panguitch, UT 84759 | 2007-10-02 |
| 1649472796 | Garfield County | Clinic/Center | 110 S 100 E, Circleville, UT 84723 | 2007-06-01 |
| 1619179751 | Garfield County | Clinic/Center | 65 N Center, Escalante, UT 84726-0276 | 2007-06-01 |
| 1790987840 | Garfield County | Clinic/Center | 425 E State St, Orderville, UT 84758 | 2007-06-01 |
| 1013119155 | Garfield County | Clinic/Center | 25 S Redrock Dr, Cannonville, UT 84718-8001 | 2007-06-01 |
| 1659402774 | Mountain Utah Family Medicine | Clinic/Center | 850 North Main St, Ste 3, Richfield, UT 84701-1848 | 2007-03-08 |
| 1043845365 | C & B Family Practice | Clinic/Center | 4601 N 16750 W, Altonah, UT 84002-0332 | 2020-03-06 |
| 1720379936 | Gregory Iverson Family Medicine Pllc | Clinic/Center | 142 South 50 East, Coalville, UT 84017-0865 | 2011-04-21 |
| 1043501257 | Gregory Iverson Family Medicine, Pllc | Clinic/Center | 228 West 200 South, Kamas, UT 84036-0159 | 2011-04-21 |
| 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.