| Riverton Family Health Center Llc | |
|
1756 Park Ave Riverton UT 84065-4701 | |
| (801) 254-0309 | |
| (801) 254-1012 |
| Full Name | Riverton Family Health Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1756 Park Ave, Riverton, Utah |
| Authorized Official Name and Position | Frederick Gary Dyson (BUSINESS DIRECTOR) |
| Authorized Official Contact | 8012540309 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverton Family Health Center Llc 1756 Park Ave Riverton UT 84065-4701 Ph: (801) 254-0309 | Riverton Family Health Center Llc 1756 Park Ave Riverton UT 84065-4701 Ph: (801) 254-0309 |
| NPI Number | 1932285186 |
|---|---|
| Provider Enumeration Date | 10/31/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6406810779 |
|---|---|
| Medicare Enrollment ID | O20041116000914 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932285186 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Utah) | Primary |
| Provider Name | Daniel O Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831186717 PECOS PAC ID: 3678464252 Enrollment ID: I20040323000880 |
| Provider Name | Don P Allred |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174510044 PECOS PAC ID: 8325030562 Enrollment ID: I20040330001580 |
| Provider Name | Rebecca M Jenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508853557 PECOS PAC ID: 4587604160 Enrollment ID: I20050504000116 |
| Provider Name | Daniel Justet Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902095631 PECOS PAC ID: 7113087503 Enrollment ID: I20081114000389 |
| Provider Name | Maria Antonia Oneida |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154350239 PECOS PAC ID: 5193785459 Enrollment ID: I20100922000548 |
| Provider Name | Ernest C Severn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326080847 PECOS PAC ID: 7214996198 Enrollment ID: I20120823000770 |
| Provider Name | Jessica C Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679967327 PECOS PAC ID: 0840594065 Enrollment ID: I20160209002104 |
| Provider Name | Justin James Banks |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1356726749 PECOS PAC ID: 6305135773 Enrollment ID: I20160525001765 |
| Provider Name | Christopher M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518402841 PECOS PAC ID: 6204118839 Enrollment ID: I20170116000692 |
| Provider Name | Jason J Tye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538682851 PECOS PAC ID: 8628336294 Enrollment ID: I20180103002736 |
| Provider Name | Eunsook G Lim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346742236 PECOS PAC ID: 3577826940 Enrollment ID: I20180417002118 |
| Provider Name | Dustin K Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083274724 PECOS PAC ID: 2567790215 Enrollment ID: I20190820001824 |
| Provider Name | Josiah Bonnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285252536 PECOS PAC ID: 5597184689 Enrollment ID: I20200826001678 |
| Provider Name | Allyson Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750993341 PECOS PAC ID: 4385056761 Enrollment ID: I20201208002253 |
| Provider Name | Jennifer J Ellstrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699441626 PECOS PAC ID: 8325433212 Enrollment ID: I20220310002196 |
| Provider Name | Brittain E Jenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417653411 PECOS PAC ID: 4082088216 Enrollment ID: I20230329002307 |
| Provider Name | Christian P Hess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649961202 PECOS PAC ID: 4688032428 Enrollment ID: I20230626003477 |
| Provider Name | Theresa B Sligting |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043086747 PECOS PAC ID: 5193160216 Enrollment ID: I20240228004127 |
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