| Sgrh Diabetes Clinic | |
|
1424 E Foremaster Dr Ste 140 St George UT 84790-5830 | |
| (435) 251-2888 | |
| Not Available |
| Full Name | Sgrh Diabetes Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 1424 E Foremaster Dr Ste 140, St George, Utah |
| Authorized Official Name and Position | Mark Briesacher (SVP - CHIEF PHY EXECUTIVE) |
| Authorized Official Contact | 8014423495 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sgrh Diabetes Clinic Po Box 27128 Salt Lake City UT 84127-0128 Ph: (435) 251-2888 | Sgrh Diabetes Clinic 1424 E Foremaster Dr Ste 140 St George UT 84790-5830 Ph: (435) 251-2888 |
| NPI Number | 1679854863 |
|---|---|
| Provider Enumeration Date | 09/01/2011 |
| Last Update Date | 01/07/2021 |
| Medicare PECOS PAC ID | 1850209420 |
|---|---|
| Medicare Enrollment ID | O20201116001486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679854863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 2392011 (Utah) | Primary |
| Provider Name | Danell Harter Gilman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609019777 PECOS PAC ID: 9537477880 Enrollment ID: I20151006001683 |
| Provider Name | Thomas Adam Burkart |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1578570800 PECOS PAC ID: 8426182270 Enrollment ID: I20201116001733 |
| Provider Name | Leslie Frances Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558735472 PECOS PAC ID: 3375846017 Enrollment ID: I20201116002311 |
| Provider Name | Mikala Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962053017 PECOS PAC ID: 0143641084 Enrollment ID: I20201116002434 |
| Provider Name | Christina Atkinson Lloyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306908264 PECOS PAC ID: 6709982762 Enrollment ID: I20201116002765 |
| Provider Name | Arne Merriman Olsen |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1821108564 PECOS PAC ID: 6709042336 Enrollment ID: I20210112002795 |
| Provider Name | Theophilus Ekpong Owan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982682647 PECOS PAC ID: 3375456312 Enrollment ID: I20210113001792 |
| Provider Name | Douglas James Wirthlin |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1609816602 PECOS PAC ID: 6002808771 Enrollment ID: I20210113002264 |
| Provider Name | Mark William Pulsipher |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689631913 PECOS PAC ID: 2365430097 Enrollment ID: I20210114000684 |
| Provider Name | Blake Isaac Gardner |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1134301997 PECOS PAC ID: 0840322954 Enrollment ID: I20210114001924 |
| Provider Name | Zachary Rand Williams |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134372584 PECOS PAC ID: 4688860422 Enrollment ID: I20210119000315 |
| Provider Name | Kevin Gregory Pollock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942679196 PECOS PAC ID: 8224346010 Enrollment ID: I20210211002657 |
| Provider Name | Deneen Marie Norman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871662957 PECOS PAC ID: 3577692797 Enrollment ID: I20210211002758 |
| Provider Name | Ryan Clark Van Woerkom |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1477871192 PECOS PAC ID: 4183879687 Enrollment ID: I20210211003246 |
| Provider Name | Nicole Justine Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942627484 PECOS PAC ID: 2860625290 Enrollment ID: I20210723001556 |
| Provider Name | Charles William Tate |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1376583526 PECOS PAC ID: 5294799748 Enrollment ID: I20211029001085 |
| Provider Name | Bradley David Hunter |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1235556382 PECOS PAC ID: 3971893702 Enrollment ID: I20220418002018 |
| Provider Name | Alisa Fallows Corry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003586876 PECOS PAC ID: 2466831110 Enrollment ID: I20220802003767 |
| Provider Name | Lisa Marie Stoddard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184294878 PECOS PAC ID: 6507234085 Enrollment ID: I20221116002720 |
| Provider Name | Rami Alharethi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1851306369 PECOS PAC ID: 3779504931 Enrollment ID: I20221123000747 |
| Provider Name | Melissa Glenn Olsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083353643 PECOS PAC ID: 8921476953 Enrollment ID: I20221205000630 |
| Provider Name | Gregory Seth Orton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356988604 PECOS PAC ID: 2961830963 Enrollment ID: I20221216001128 |
| Provider Name | Kyle Clark Kimbal |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1104205442 PECOS PAC ID: 6406137504 Enrollment ID: I20230320000249 |
| Provider Name | Richard Kevin Gilroy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255389060 PECOS PAC ID: 6608969233 Enrollment ID: I20230718002913 |
| Provider Name | Geoffrey Joseph Orme |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386906881 PECOS PAC ID: 3173889870 Enrollment ID: I20231113001624 |
| Provider Name | Daanish Hoda |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1043308380 PECOS PAC ID: 9234137167 Enrollment ID: I20231208000761 |
| Provider Name | Andy Nguyen |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1033362694 PECOS PAC ID: 1355474347 Enrollment ID: I20240102001787 |
| Provider Name | Kenneth Lightheart |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1740290360 PECOS PAC ID: 2365543600 Enrollment ID: I20240117002913 |
| Provider Name | Ralph Jensen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750351029 PECOS PAC ID: 7810167012 Enrollment ID: I20240129003495 |
| Provider Name | Bryan Huber |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1982049227 PECOS PAC ID: 8729228879 Enrollment ID: I20240205000590 |
| Provider Name | James F. Trotter |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225128903 PECOS PAC ID: 7113991191 Enrollment ID: I20240422002956 |
| Provider Name | Jordan Hays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215339957 PECOS PAC ID: 9032440631 Enrollment ID: I20240515002288 |
| Provider Name | Kelly L Konopa |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1033272489 PECOS PAC ID: 3779643010 Enrollment ID: I20240523002506 |
Pure Life Health And Wellness Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 617 E Riverside Dr Ste 104, St George, UT 84790 Phone: 801-638-7826 | |
Feliciacbodyworks Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 352 E Riverside Dr Ste A1, St George, UT 84790 Phone: 435-669-8992 | |
Southwest Internal Medicine, P. C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 736 S 900 E, Suite 104, St George, UT 84790 Phone: 435-628-9200 Fax: 435-674-5763 | |
Concierge Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1224 S River Rd Ste B101, St George, UT 84790 Phone: 435-236-0835 | |
William T Graff Md Faafp Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 630 S 400 E Ste 101, St George, UT 84770 Phone: 435-673-9653 | |
Amara Health And Wellness Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 558 E Riverside Dr, Ste 200, St George, UT 84790 Phone: 435-652-9355 | |
Women's Wellness, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 North 200 East, Suite 2c, St George, UT 84770 Phone: 435-674-1700 Fax: 435-674-4681 |