| |
598 W 900 S Ste 230 Woods Cross UT 84010-8195 | |
(801) 397-4040 | |
(801) 693-2399 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 598 W 900 S Ste 230, Woods Cross, Utah |
Authorized Official Name and Position | Edward Bangerter (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 8013974101 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
598 W 900 S Ste 230 Woods Cross UT 84010-8195 Ph: (801) 397-4040 | 598 W 900 S Ste 230 Woods Cross UT 84010-8195 Ph: (801) 397-4040 |
NPI Number | 1134721228 |
---|---|
Provider Enumeration Date | 11/12/2020 |
Last Update Date | 02/05/2025 |
Medicare PECOS PAC ID | 6305260746 |
---|---|
Medicare Enrollment ID | O20200720000334 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134721228 | NPI | - | NPPES |
Provider Name | Kellie Daugharty Lewis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750467155 PECOS PAC ID: 7113831983 Enrollment ID: I20031117000146 |
Provider Name | Jeffrey D Johnson |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1447323886 PECOS PAC ID: 4385531201 Enrollment ID: I20040303001155 |
Provider Name | Glen F Biddulph |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1518999275 PECOS PAC ID: 1355381591 Enrollment ID: I20050506000779 |
Provider Name | Vera Carlson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023095585 PECOS PAC ID: 8921057803 Enrollment ID: I20051213000106 |
Provider Name | Kraig Lynn Packer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518959535 PECOS PAC ID: 3779471412 Enrollment ID: I20080520000842 |
Provider Name | Matthew Michael Schellenberg |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1386855021 PECOS PAC ID: 0941371173 Enrollment ID: I20080616000770 |
Provider Name | Stephen J Bruce |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1841269321 PECOS PAC ID: 6608906052 Enrollment ID: I20100610000617 |
Provider Name | David Smith |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1154575637 PECOS PAC ID: 4486779204 Enrollment ID: I20100917000078 |
Provider Name | Garth James Muir |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1326200627 PECOS PAC ID: 1052451705 Enrollment ID: I20130222000113 |
Provider Name | Jedediah Briscoe |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962650184 PECOS PAC ID: 5698990513 Enrollment ID: I20140709003046 |
Provider Name | Janis Maag |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982112587 PECOS PAC ID: 2466712054 Enrollment ID: I20180130000994 |
Provider Name | Joni Hamblin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376007237 PECOS PAC ID: 9931441888 Enrollment ID: I20200107001649 |
Provider Name | Teya C Wilson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063186872 PECOS PAC ID: 9638569866 Enrollment ID: I20211202001813 |
Provider Name | Sheila R Mioni |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619639242 PECOS PAC ID: 0648660209 Enrollment ID: I20211214001837 |
Provider Name | Michelle Jenkins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376144402 PECOS PAC ID: 2264819366 Enrollment ID: I20220511000459 |
Provider Name | Donna Larhesa Callas |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902536311 PECOS PAC ID: 9335511013 Enrollment ID: I20230206001678 |
Provider Name | Spencer Keith Noyce |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740934488 PECOS PAC ID: 0840646162 Enrollment ID: I20231023003219 |
Provider Name | Thomas Jay Cox |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508511163 PECOS PAC ID: 6608223847 Enrollment ID: I20231109003211 |
Provider Name | Carley A Florence |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235990565 PECOS PAC ID: 1850737818 Enrollment ID: I20240312004212 |
Rocky Mountain Care - Palliative Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 598 W 900 S Ste 105, Woods Cross, UT 84010 Phone: 801-693-2380 Fax: 801-693-2379 | |
Grandview Family Counseling Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1576 S 500 W Ste 202, Woods Cross, UT 84010 Phone: 801-550-9057 Fax: 801-294-5286 | |
Brett J Earl Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1576 S 500 W, Suite 101, Woods Cross, UT 84010 Phone: 801-303-7329 Fax: 801-303-7329 |