Foothill Family Clinic | |
2295 Foothill Dr Salt Lake City UT 84109-4000 | |
(801) 486-3021 | |
(801) 485-6339 |
Full Name | Foothill Family Clinic |
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Speciality | Family Medicine |
Location | 2295 Foothill Dr, Salt Lake City, Utah |
Authorized Official Name and Position | Dan C. Henry (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 8014863021 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Foothill Family Clinic 2295 Foothill Dr Salt Lake City UT 84109-4000 Ph: (801) 486-3021 | Foothill Family Clinic 2295 Foothill Dr Salt Lake City UT 84109-4000 Ph: (801) 486-3021 |
NPI Number | 1407947005 |
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Provider Enumeration Date | 09/27/2006 |
Last Update Date | 09/15/2008 |
Medicare PECOS PAC ID | 9931003795 |
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Medicare Enrollment ID | O20031122000151 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407947005 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Stephen D Wood |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1508881657 PECOS PAC ID: 2668376427 Enrollment ID: I20040817001357 |
Provider Name | James P Longe |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1093730129 PECOS PAC ID: 6103720966 Enrollment ID: I20040817001377 |
Provider Name | Jack A Taylor |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1467477505 PECOS PAC ID: 1759285513 Enrollment ID: I20040818000160 |
Provider Name | Susan L Edwards |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1992730139 PECOS PAC ID: 5294639068 Enrollment ID: I20040818000168 |
Provider Name | Dan C Henry |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1871528018 PECOS PAC ID: 0840194601 Enrollment ID: I20040818000176 |
Provider Name | Shane G Christensen |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1861427189 PECOS PAC ID: 6103720974 Enrollment ID: I20040818000187 |
Provider Name | Stephen D Coleman |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1891720124 PECOS PAC ID: 3476457243 Enrollment ID: I20040818000240 |
Provider Name | Bryan L Nelson |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1346265477 PECOS PAC ID: 4385548155 Enrollment ID: I20040818000251 |
Provider Name | Wesley J Lewis |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1013932144 PECOS PAC ID: 2567366321 Enrollment ID: I20040818000270 |
Provider Name | Ross A Brunetti |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1700811023 PECOS PAC ID: 7012811888 Enrollment ID: I20040818000287 |
Provider Name | John E Witbeck |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972522316 PECOS PAC ID: 0749184505 Enrollment ID: I20040818000292 |
Provider Name | James T Peterson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316962442 PECOS PAC ID: 0749184513 Enrollment ID: I20040818000312 |
Provider Name | Thomas K Conner |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1780619023 PECOS PAC ID: 1557334489 Enrollment ID: I20040818000333 |
Provider Name | Gina B Cox |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1396770533 PECOS PAC ID: 7618940552 Enrollment ID: I20040818000371 |
Provider Name | Dorothy L Williams |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1619992708 PECOS PAC ID: 3173561669 Enrollment ID: I20050425000867 |
Provider Name | Shana K Eborn |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1780615658 PECOS PAC ID: 5890776561 Enrollment ID: I20050729000238 |
Provider Name | Alexander Clark |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1578772109 PECOS PAC ID: 0446344493 Enrollment ID: I20070920000737 |
Provider Name | Heather Jackson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023237088 PECOS PAC ID: 9436210556 Enrollment ID: I20081209000069 |
Provider Name | Jacqueline L Rohrer |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1225296387 PECOS PAC ID: 9335306794 Enrollment ID: I20120214000099 |
Provider Name | Jose Azarcon |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1285627455 PECOS PAC ID: 8628977022 Enrollment ID: I20121026000076 |
Provider Name | Joseph Sterling Atkin |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1932428232 PECOS PAC ID: 7315106648 Enrollment ID: I20140528001613 |
Provider Name | Benjamin A Thomas |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1043659055 PECOS PAC ID: 9638460843 Enrollment ID: I20160620000284 |
Provider Name | Holly Anderson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609239946 PECOS PAC ID: 8527331412 Enrollment ID: I20170828003603 |
Provider Name | Jessica Wilkinson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1093179160 PECOS PAC ID: 2860788007 Enrollment ID: I20190621000370 |
Provider Name | Daniel Mark Payne |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952861288 PECOS PAC ID: 5496171613 Enrollment ID: I20200819001158 |
Provider Name | Terrell Lyles Glenn |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972990174 PECOS PAC ID: 8820394976 Enrollment ID: I20201130000633 |
Provider Name | London Teri Jackson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902416795 PECOS PAC ID: 4183035835 Enrollment ID: I20201201002014 |
Provider Name | Jordan Blake Butterfield |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1336638485 PECOS PAC ID: 6305249400 Enrollment ID: I20210727003325 |
Provider Name | Rachelle Huber Dustin |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1851064810 PECOS PAC ID: 7214334036 Enrollment ID: I20210921003720 |
Provider Name | Madeleine Elise Rupert |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386340115 PECOS PAC ID: 7719350594 Enrollment ID: I20230224002057 |
Provider Name | Michael Jones |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1093344905 PECOS PAC ID: 7517357494 Enrollment ID: I20230727002450 |
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