COTTONWOOD MEDICAL CLINIC,PLLC (NPI# 1972992477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972992477 |
| Entity Type | Organization |
| Organization Name | COTTONWOOD MEDICAL CLINIC,PLLC |
| Practice Address |
6671 S Redwood Rd Ste 110 West Jordan UT 84084-7488 |
| Mailing Address |
8414 S Kings Cove Dr Salt Lake City UT 84121-6064 |
| Practice Telephone | 8015712452 |
| Practice Fax Number | 8669360188 |
| Mailing Telephone | 8012314932 |
| Mailing Fax Number | 8669360188 |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2015-01-30 |
| Authorized Official Name | ANN LAPOLLA (OWNER) |
| Authorized Official Telephone | 8012314932 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SA2100X |
Clinical Nurse Specialist Specialization: Acute Care |
2121144405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | STATE LICENSE | 2121144405 | 01 |
| Street Address |
6671 S REDWOOD RD STE 110 |
| City | WEST JORDAN |
| State | UT |
| Zip Code | 84084-7488 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497720080 | Heartwood Home Health & Hospice, LLC | Hospice Care, Community Based | 6671 S Redwood Rd, Suite #101, West Jordan, UT 84084-7488 | 2006-02-17 |
| 1588869838 | Heartwood Home Health & Hospice, LLC | Home Health | 6671 S Redwood Rd, Suite 101, West Jordan, UT 84084-7488 | 2007-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396351383 | National Vision Inc | Optometrist | 3857 West Campus View Drive, Suite 110, West Jordan, UT 84084 | 2020-09-16 |
| 1386267938 | Parker Brown | Dentist | Jordan Valley Dental, 7452 S Campus Drive, West Jordan, UT 84084 | 2020-05-18 |
| 1952809873 | David D. Allred Counseling & Consulting, LLC | Marriage & Family Therapist | 1365 W Green Hedge Way, West Jordan, UT 84084 | 2018-01-25 |
| 1720514268 | Utah Podiatric Physicians and Surgeons Group LLC | Podiatrist | 7000 S 1561 W, #100, West Jordan, UT 84084 | 2017-05-03 |
| 1245787829 | Josh Sullivan | Social Worker | 7395 S Paddington Rd, West Jordan, UT 84084 | 2016-09-01 |
| 1457752503 | Eaze Bracing | Prosthetic/Orthotic Supplier | 1324 W 7125 S, West Jordan, UT 84084 | 2014-09-09 |
| 1437595030 | Medico Transport System | Ambulance | 7365 S 4570 W, South Jordan, UT 84084 | 2013-05-22 |
| 1659612737 | Lifecare Specialty | Pharmacy | 1646 Sunrise Place Ste B, West Jordan, UT 84084 | 2013-03-14 |
| 1518217942 | Luciane Lopes De Oliveira | Student in an Organized Health Care Education/Training Program | 7601 Redwood Road, West Jordan, UT 84084 | 2012-09-13 |
| 1023368636 | Chelsey Tautkus | Social Worker | 7601 South Redwood Road, Building E, West Jordan, UT 84084 | 2012-09-12 |
| Find all providers in zip 84084 | ||||
| Taxonomy Code | 364SA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952774283 | Jenna Sweet | Clinical Nurse Specialist | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2015-11-09 |
| 1053741900 | Mary Morgal | Clinical Nurse Specialist | 4401 Harrison Blvd, Ogden, UT 84403-3195 | 2013-11-13 |
| 1659625770 | Daniel Knitz | Clinical Nurse Specialist | 50 N Medical Dr, Slc, UT 84132-0001 | 2012-10-29 |
| 1114151115 | Yuko Matsuoka | Clinical Nurse Specialist | 2000 Circle of Hope Dr, Salt Lake City, UT 84112-5550 | 2009-05-06 |
| City | WEST JORDAN |
| Zip Code | 84084 |
Please comment or provide details below to improve the information on COTTONWOOD MEDICAL CLINIC,PLLC.
| 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.