| Jupiter Medical Ii Llc | |
|
7724 S 5600 W Ste 102 West Jordan UT 84081-5415 | |
| (801) 432-8480 | |
| (435) 731-8328 |
| Full Name | Jupiter Medical Ii Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7724 S 5600 W Ste 102, West Jordan, Utah |
| Authorized Official Name and Position | Bryan Knepper (OWNER) |
| Authorized Official Contact | 6175713680 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jupiter Medical Ii Llc 21 White Hill Rd Cold Spring Harbor NY 11724-1211 Ph: (617) 571-3680 | Jupiter Medical Ii Llc 7724 S 5600 W Ste 102 West Jordan UT 84081-5415 Ph: (801) 432-8480 |
| NPI Number | 1649790080 |
|---|---|
| Provider Enumeration Date | 06/27/2017 |
| Last Update Date | 06/27/2017 |
| Medicare PECOS PAC ID | 5395011308 |
|---|---|
| Medicare Enrollment ID | O20171018003271 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649790080 | NPI | - | NPPES |
| U000092310 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Jennifer A. Knepper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437196144 PECOS PAC ID: 5799740361 Enrollment ID: I20150930000633 |
| Provider Name | Jacqueline Romrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447690235 PECOS PAC ID: 9436468139 Enrollment ID: I20151020002339 |
| Provider Name | Melissa Areinamo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811234917 PECOS PAC ID: 1759526882 Enrollment ID: I20161114001663 |
| Provider Name | Mandy Lynn Pattillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336662519 PECOS PAC ID: 2860763646 Enrollment ID: I20170814000687 |
| Provider Name | Erin M Burt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235651506 PECOS PAC ID: 4385916758 Enrollment ID: I20170818002583 |
| Provider Name | Jessica Coon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538518469 PECOS PAC ID: 3779840582 Enrollment ID: I20171204002116 |
| Provider Name | Hosanna Angelina Clay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306344973 PECOS PAC ID: 1658631684 Enrollment ID: I20180212001649 |
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