| Catholic Health Initiatives Colorado | |
|
3460 S 4155 W West Valley City UT 84120 | |
| (801) 964-3111 | |
| (801) 964-3752 |
| Full Name | Catholic Health Initiatives Colorado |
|---|---|
| Speciality | Psychologist |
| Location | 3460 S 4155 W, West Valley City, Utah |
| Authorized Official Name and Position | Angela J Skinner (ADMINISTRATOR, OMA) |
| Authorized Official Contact | 3036737175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Catholic Health Initiatives Colorado Po Box 800022 Kansas City MO 64180-0022 Ph: (800) 953-0104 | Catholic Health Initiatives Colorado 3460 S 4155 W West Valley City UT 84120 Ph: (801) 964-3111 |
| NPI Number | 1942903562 |
|---|---|
| Provider Enumeration Date | 03/23/2023 |
| Last Update Date | 03/23/2023 |
| Certification Date | 03/21/2023 |
| Medicare PECOS PAC ID | 8022927342 |
|---|---|
| Medicare Enrollment ID | O20230615001995 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942903562 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | (* (Not Available)) | Primary |
| Provider Name | Jololene Allan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316017627 PECOS PAC ID: 5890608210 Enrollment ID: I20031111000285 |
| Provider Name | Konstantyn Y Szwajkun |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508849191 PECOS PAC ID: 9436063161 Enrollment ID: I20031117000919 |
| Provider Name | Karen A Boheen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467452383 PECOS PAC ID: 6507765088 Enrollment ID: I20040105000036 |
| Provider Name | Brent T Watson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225129158 PECOS PAC ID: 0446153787 Enrollment ID: I20040202000653 |
| Provider Name | William Marcus Brann |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912087826 PECOS PAC ID: 9931090776 Enrollment ID: I20040322001782 |
| Provider Name | James Rasmussen |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1770661712 PECOS PAC ID: 9133114788 Enrollment ID: I20040414001978 |
| Provider Name | David E Curtis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730222720 PECOS PAC ID: 0648160515 Enrollment ID: I20040603001438 |
| Provider Name | Clarke A Hilbig |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861404758 PECOS PAC ID: 0648255968 Enrollment ID: I20040621001995 |
| Provider Name | Gregory D Hammond |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1942374020 PECOS PAC ID: 2264410976 Enrollment ID: I20040709000664 |
| Provider Name | Kathryn J Waddell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891833257 PECOS PAC ID: 8022079482 Enrollment ID: I20041020000394 |
| Provider Name | Rebecca I Tanner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629050067 PECOS PAC ID: 6709847072 Enrollment ID: I20041022000935 |
| Provider Name | Cathey A Putnam |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437110368 PECOS PAC ID: 6901717644 Enrollment ID: I20041229000221 |
| Provider Name | Joel D Macdonald |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1487744090 PECOS PAC ID: 5991750267 Enrollment ID: I20050318000883 |
| Provider Name | Mary E James |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710927975 PECOS PAC ID: 4587604665 Enrollment ID: I20050509000673 |
| Provider Name | Kevin B. Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255456497 PECOS PAC ID: 5193636835 Enrollment ID: I20050810000127 |
| Provider Name | Wei Peng |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1295831865 PECOS PAC ID: 9032140868 Enrollment ID: I20050822001152 |
| Provider Name | Andrew D Cooper |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477547164 PECOS PAC ID: 5991761421 Enrollment ID: I20050825000404 |
| Provider Name | Kashif A Memon |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1932161668 PECOS PAC ID: 2668404278 Enrollment ID: I20050902000744 |
| Provider Name | James C Stringham |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1538182449 PECOS PAC ID: 6103843271 Enrollment ID: I20051027000987 |
| Provider Name | Barclay F Bigelow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588617542 PECOS PAC ID: 8325067762 Enrollment ID: I20051115000939 |
| Provider Name | Roger Borchardt |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386637833 PECOS PAC ID: 1850310103 Enrollment ID: I20051115001145 |
| Provider Name | Randall L Watson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952341000 PECOS PAC ID: 2466471313 Enrollment ID: I20051121000340 |
| Provider Name | Douglas P Barney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013081801 PECOS PAC ID: 6002838596 Enrollment ID: I20051227000589 |
| Provider Name | Grant E Hawkins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255341806 PECOS PAC ID: 6800819624 Enrollment ID: I20060107000069 |
| Provider Name | John C Luras |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619084928 PECOS PAC ID: 5991789422 Enrollment ID: I20060113000335 |
| Provider Name | Heather L Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427080670 PECOS PAC ID: 0941224018 Enrollment ID: I20060117000777 |
| Provider Name | Bruce R Kenwood |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1144279019 PECOS PAC ID: 2567465792 Enrollment ID: I20060808000586 |
| Provider Name | Wade M Sessions |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1659483816 PECOS PAC ID: 8628075553 Enrollment ID: I20061106000601 |
| Provider Name | David Klein |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1124075437 PECOS PAC ID: 0143121582 Enrollment ID: I20070208000132 |
| Provider Name | Vivian M Dearden |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1437260510 PECOS PAC ID: 7719084813 Enrollment ID: I20070524000613 |
| Provider Name | Armen Khachatryan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114930781 PECOS PAC ID: 3678673365 Enrollment ID: I20070710000958 |
| Provider Name | Mohammad Shoari |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740483395 PECOS PAC ID: 5294827630 Enrollment ID: I20070815000494 |
| Provider Name | James D Burrows |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1477506913 PECOS PAC ID: 0446342000 Enrollment ID: I20080129000163 |
| Provider Name | David R Zackrison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346364775 PECOS PAC ID: 0345324141 Enrollment ID: I20080303000321 |
| Provider Name | Florin R Nielsen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508811639 PECOS PAC ID: 2668542184 Enrollment ID: I20080610000156 |
| Provider Name | David Samuel Massinople |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255541785 PECOS PAC ID: 9537247770 Enrollment ID: I20080715000047 |
| Provider Name | Christina M Francis |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1780702605 PECOS PAC ID: 5294894945 Enrollment ID: I20081110000478 |
| Provider Name | Sajid Faizi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659386357 PECOS PAC ID: 8224185756 Enrollment ID: I20090420000492 |
| Provider Name | Adam M Elhaddi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1972713568 PECOS PAC ID: 6406827302 Enrollment ID: I20090805000408 |
| Provider Name | Jeffrey S Devaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376716399 PECOS PAC ID: 7416001185 Enrollment ID: I20090814000018 |
| Provider Name | Elizabeth Cain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619195799 PECOS PAC ID: 9830235936 Enrollment ID: I20091002000396 |
| Provider Name | Jonathan P Daniels |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043214935 PECOS PAC ID: 8325101223 Enrollment ID: I20091012000144 |
| Provider Name | Stacie B Carter |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1710180591 PECOS PAC ID: 6103965843 Enrollment ID: I20091209000289 |
| Provider Name | Bruce G Evans |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942292446 PECOS PAC ID: 9032124607 Enrollment ID: I20100628000461 |
| Provider Name | Chad Carman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427129535 PECOS PAC ID: 2567491533 Enrollment ID: I20100802000885 |
| Provider Name | Dinhkim Le |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588845101 PECOS PAC ID: 2365567021 Enrollment ID: I20100917000691 |
| Provider Name | Trevor H Magee |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1154543361 PECOS PAC ID: 2466578653 Enrollment ID: I20100924000714 |
| Provider Name | Stephen D Lash |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447228572 PECOS PAC ID: 9931225026 Enrollment ID: I20100927000359 |
| Provider Name | Isaac D Alfaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093817884 PECOS PAC ID: 1456545102 Enrollment ID: I20101027000558 |
| Provider Name | Peter R Silvero |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1699844001 PECOS PAC ID: 6709943079 Enrollment ID: I20101108000458 |
| Provider Name | Rebecca Reiser |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639336795 PECOS PAC ID: 9436201902 Enrollment ID: I20110114000854 |
| Provider Name | Pragati Hooda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962735670 PECOS PAC ID: 0749469617 Enrollment ID: I20110124001293 |
| Provider Name | Clark W Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487706099 PECOS PAC ID: 8729166285 Enrollment ID: I20110314000988 |
| Provider Name | Chi-gang Yen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447373576 PECOS PAC ID: 8921154998 Enrollment ID: I20110627000380 |
| Provider Name | Richard J Donaldson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841495066 PECOS PAC ID: 7214107739 Enrollment ID: I20111019000958 |
| Provider Name | Christopher J Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245550268 PECOS PAC ID: 5193983369 Enrollment ID: I20120220000126 |
| Provider Name | Sarah Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992082556 PECOS PAC ID: 0244499135 Enrollment ID: I20120313000484 |
| Provider Name | Garrett Reed Bird |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1164638573 PECOS PAC ID: 2062505001 Enrollment ID: I20120703000673 |
| Provider Name | Christopher J Vinegra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134198633 PECOS PAC ID: 4880843994 Enrollment ID: I20121005000116 |
| Provider Name | Megan J Engelen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154529246 PECOS PAC ID: 7911188727 Enrollment ID: I20121018000760 |
| Provider Name | David Lee Skalka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851692735 PECOS PAC ID: 0941204333 Enrollment ID: I20121119000300 |
| Provider Name | Jeffrey L Eakin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932308822 PECOS PAC ID: 0749458552 Enrollment ID: I20130708000378 |
| Provider Name | Benjamin G Williams |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1013184431 PECOS PAC ID: 4880834258 Enrollment ID: I20130708000394 |
| Provider Name | Kendall A Grose |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245406776 PECOS PAC ID: 9638218779 Enrollment ID: I20130711000096 |
| Provider Name | Benjamin David Curtis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124299714 PECOS PAC ID: 4385885490 Enrollment ID: I20130731000748 |
| Provider Name | Jason E Crook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194161190 PECOS PAC ID: 2668616038 Enrollment ID: I20130925000385 |
| Provider Name | Zoe A Robbins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134321508 PECOS PAC ID: 6507090800 Enrollment ID: I20130927000285 |
| Provider Name | Michael Jon Vreeland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295176410 PECOS PAC ID: 2769610484 Enrollment ID: I20140102000052 |
| Provider Name | Justin David Atherton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386876167 PECOS PAC ID: 5395926703 Enrollment ID: I20140612001996 |
| Provider Name | Jared Chesley Martin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639499783 PECOS PAC ID: 4284859984 Enrollment ID: I20140715000188 |
| Provider Name | Bart Steven Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760788160 PECOS PAC ID: 5991920530 Enrollment ID: I20140715001767 |
| Provider Name | Catherine E Beck |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922267459 PECOS PAC ID: 1153564810 Enrollment ID: I20141112001817 |
| Provider Name | Randi Hollis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346642121 PECOS PAC ID: 2769707256 Enrollment ID: I20150204000008 |
| Provider Name | Curtis Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962806786 PECOS PAC ID: 3274859012 Enrollment ID: I20150313000586 |
| Provider Name | Ashley D Nelson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235348699 PECOS PAC ID: 9931377595 Enrollment ID: I20150321000365 |
| Provider Name | Jarin Kent Leavitt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427341726 PECOS PAC ID: 3870807506 Enrollment ID: I20150807015147 |
| Provider Name | Paul G Goff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831576669 PECOS PAC ID: 3971810334 Enrollment ID: I20150916003544 |
| Provider Name | John W Thatcher |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407933708 PECOS PAC ID: 4688974579 Enrollment ID: I20151125001104 |
| Provider Name | Heather Ann Scott |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1144685603 PECOS PAC ID: 6002119708 Enrollment ID: I20160128002603 |
| Provider Name | Robert W Engelen |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1053494393 PECOS PAC ID: 6608006176 Enrollment ID: I20160516002046 |
| Provider Name | Jordy C Cox |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295833457 PECOS PAC ID: 4587637624 Enrollment ID: I20160527001404 |
| Provider Name | Julia Ansari |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780846881 PECOS PAC ID: 1355574880 Enrollment ID: I20160603000186 |
| Provider Name | Joshua Gary Hunter |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861634081 PECOS PAC ID: 4385956051 Enrollment ID: I20160825001052 |
| Provider Name | Aubrey Atkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043614795 PECOS PAC ID: 7113148545 Enrollment ID: I20160926000899 |
| Provider Name | Jared Samuel Gates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275986952 PECOS PAC ID: 8921380437 Enrollment ID: I20170118000797 |
| Provider Name | Rocky D Howell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225580186 PECOS PAC ID: 1759665201 Enrollment ID: I20170228001505 |
| Provider Name | Matthew R Allred |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194262022 PECOS PAC ID: 2769769157 Enrollment ID: I20170512001422 |
| Provider Name | Dallin L Demordaunt |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1336128388 PECOS PAC ID: 5890723142 Enrollment ID: I20170622001960 |
| Provider Name | Brittany Lee Sprague |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912427584 PECOS PAC ID: 5395014245 Enrollment ID: I20170707002664 |
| Provider Name | Kyle Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912435421 PECOS PAC ID: 7214208487 Enrollment ID: I20170807000868 |
| Provider Name | Devin Reid Tranter |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1528409513 PECOS PAC ID: 3274804141 Enrollment ID: I20170810003059 |
| Provider Name | Brandon C Green |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1184864563 PECOS PAC ID: 7416112214 Enrollment ID: I20171012002616 |
| Provider Name | Diane W Allred |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770911448 PECOS PAC ID: 7618243973 Enrollment ID: I20171101001170 |
| Provider Name | Snigdha Ancha |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1851679351 PECOS PAC ID: 9931465747 Enrollment ID: I20171110002581 |
| Provider Name | Kristen Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205288628 PECOS PAC ID: 8820355753 Enrollment ID: I20171201001730 |
| Provider Name | Nathan L. Boyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912494345 PECOS PAC ID: 4688920747 Enrollment ID: I20180702002940 |
| Provider Name | Nicholas M Noble |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316329329 PECOS PAC ID: 1850649963 Enrollment ID: I20180807000681 |
| Provider Name | Ashley Elizabeth Hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427443449 PECOS PAC ID: 9032411905 Enrollment ID: I20181026000553 |
| Provider Name | Anthony Glen Edwards |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1598024275 PECOS PAC ID: 9133434509 Enrollment ID: I20181221001211 |
| Provider Name | Kristina Simons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982683777 PECOS PAC ID: 2163762436 Enrollment ID: I20190322002087 |
| Provider Name | Julia Margarita Kammel |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1407210446 PECOS PAC ID: 9032485651 Enrollment ID: I20190603002332 |
| Provider Name | Trenton Lane Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184280869 PECOS PAC ID: 1658605050 Enrollment ID: I20190618002937 |
| Provider Name | Raylene Natwick |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093129173 PECOS PAC ID: 9234356676 Enrollment ID: I20190830001184 |
| Provider Name | Wesley Deans |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104212877 PECOS PAC ID: 9638483704 Enrollment ID: I20190924002867 |
| Provider Name | Emily D Janata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558816223 PECOS PAC ID: 7719311281 Enrollment ID: I20191217001501 |
| Provider Name | Kimberly Rashelle Weir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588215750 PECOS PAC ID: 4385079490 Enrollment ID: I20200120000208 |
| Provider Name | Christopher Murphy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215900584 PECOS PAC ID: 2365689486 Enrollment ID: I20200127002373 |
| Provider Name | Heather Wark |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457705279 PECOS PAC ID: 7911263439 Enrollment ID: I20200615002278 |
| Provider Name | Marvin Rios |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992190680 PECOS PAC ID: 4789973595 Enrollment ID: I20200730002518 |
| Provider Name | Lindsay Lawrence |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548622756 PECOS PAC ID: 8628495728 Enrollment ID: I20200903002954 |
| Provider Name | Cara Marie Guilfoyle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114181930 PECOS PAC ID: 3375706682 Enrollment ID: I20201007003408 |
| Provider Name | Jamee Schelin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952929358 PECOS PAC ID: 6204256092 Enrollment ID: I20201016000176 |
| Provider Name | Erica Kueneman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629675673 PECOS PAC ID: 4284044397 Enrollment ID: I20201030001830 |
| Provider Name | Mackenzie Goodwin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942569231 PECOS PAC ID: 2365674447 Enrollment ID: I20201208001373 |
| Provider Name | Kevin Sagers |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194102657 PECOS PAC ID: 4183041684 Enrollment ID: I20210727000991 |
| Provider Name | Gregory Anderson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003295593 PECOS PAC ID: 1658683693 Enrollment ID: I20210811000248 |
| Provider Name | Jonathan Drew Gurney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710651047 PECOS PAC ID: 0648676361 Enrollment ID: I20210903002508 |
| Provider Name | Leticia Haacke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376822098 PECOS PAC ID: 4981001401 Enrollment ID: I20210927002104 |
| Provider Name | Justin Meuse |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518100742 PECOS PAC ID: 7214181643 Enrollment ID: I20210930002224 |
| Provider Name | Russell Vollmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962813253 PECOS PAC ID: 4587888938 Enrollment ID: I20211025002661 |
| Provider Name | Kathleen Sherrie Rich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588236442 PECOS PAC ID: 6901296011 Enrollment ID: I20211203002284 |
| Provider Name | Jessica Lagoo |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1396401980 PECOS PAC ID: 0143610873 Enrollment ID: I20211210002115 |
| Provider Name | Patricio Mendoza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184375370 PECOS PAC ID: 2466845029 Enrollment ID: I20220203002433 |
| Provider Name | Andrew Covington |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1104261874 PECOS PAC ID: 2567738198 Enrollment ID: I20220215001237 |
| Provider Name | Erin Batin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245780808 PECOS PAC ID: 7214351592 Enrollment ID: I20220321001786 |
| Provider Name | Peggy Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841862059 PECOS PAC ID: 3274911060 Enrollment ID: I20220607002405 |
| Provider Name | Maria Alejandra Gonzalez Ferrua |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427549435 PECOS PAC ID: 6002295128 Enrollment ID: I20220621001876 |
| Provider Name | Jeffrey Pence |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1265963722 PECOS PAC ID: 0042582843 Enrollment ID: I20220711002219 |
| Provider Name | Tyler Kent |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1740676501 PECOS PAC ID: 8729374384 Enrollment ID: I20220822000957 |
| Provider Name | Puanani Anna May Spencer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679817324 PECOS PAC ID: 8921477944 Enrollment ID: I20221214002783 |
| Provider Name | Trevor Tonks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639816168 PECOS PAC ID: 9537532379 Enrollment ID: I20230227001722 |
| Provider Name | Lydia Weyenberg |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407381650 PECOS PAC ID: 4486048592 Enrollment ID: I20230808000822 |
| Provider Name | Jason Neil Beckstrand |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1972000222 PECOS PAC ID: 4981066057 Enrollment ID: I20230822001662 |
| Provider Name | Broc A Durrant |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891145728 PECOS PAC ID: 7517217128 Enrollment ID: I20230822004341 |
| Provider Name | Lisa M Hill |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1033998315 PECOS PAC ID: 2163878547 Enrollment ID: I20231020000865 |
| Provider Name | Chelsey Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972377307 PECOS PAC ID: 9931551926 Enrollment ID: I20240116000149 |
| Provider Name | Anthony Thomas Nixon |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841871522 PECOS PAC ID: 1951754571 Enrollment ID: I20240131001355 |
| Provider Name | Jaxon Reid |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528724069 PECOS PAC ID: 8921451543 Enrollment ID: I20240131001450 |
| Provider Name | Christopher Charles Beers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689458606 PECOS PAC ID: 8820441389 Enrollment ID: I20240131003071 |
| Provider Name | Elizabeth Givogue |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417192212 PECOS PAC ID: 8123462553 Enrollment ID: I20240214000288 |
| Provider Name | Stephanie E Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730959990 PECOS PAC ID: 8527403112 Enrollment ID: I20240305003765 |
Rivercourse Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3556 S 5600 W # 1-660, West Valley City, UT 84120 Phone: 612-930-2038 | |
Sacred Spaces Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7296 W Sentinal Rd, West Valley City, UT 84081 Phone: 801-815-6905 | |
Metrodora Clinic, Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3535 S Market St Ste 800, West Valley City, UT 84119 Phone: 801-907-1796 | |
Isat Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1555 West 2200 South, Suite A, West Valley City, UT 84119 Phone: 801-886-8900 Fax: 801-886-8898 | |
West Counseling Offices Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2880 W 4700 S, Suite A, West Valley City, UT 84118 Phone: 801-964-2465 Fax: 801-964-9075 | |
Glen E Johnson Md Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3940 W 4100 S, West Valley City, UT 84120 Phone: 801-966-3700 Fax: 801-966-9421 | |
Ri International Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2411 S 1070 W Ste A, West Valley City, UT 84119 Phone: 602-650-1212 |