| Ogden Clinic Pc | |
|
4650 Harrison Blvd Ogden UT 84403-4303 | |
| (801) 475-3000 | |
| (801) 475-3494 |
| Full Name | Ogden Clinic Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4650 Harrison Blvd, Ogden, Utah |
| Authorized Official Name and Position | Chad Tingey (BOARD PRESIDENT) |
| Authorized Official Contact | 8014753481 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ogden Clinic Pc Po Box 5546 Denver CO 80217-5546 Ph: (801) 475-3481 | Ogden Clinic Pc 4650 Harrison Blvd Ogden UT 84403-4303 Ph: (801) 475-3000 |
| NPI Number | 1114203668 |
|---|---|
| Provider Enumeration Date | 10/28/2011 |
| Last Update Date | 10/23/2020 |
| Medicare PECOS PAC ID | 1658781422 |
|---|---|
| Medicare Enrollment ID | O20201105001806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114203668 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | 5776572-1206 (Utah) | Secondary |
| Provider Name | Michael L Hadley |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1699797811 PECOS PAC ID: 8628972486 Enrollment ID: I20031122000115 |
| Provider Name | Curt R Stock |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1275681686 PECOS PAC ID: 5496653990 Enrollment ID: I20031230000195 |
| Provider Name | Demetrios G Skedros |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1821146242 PECOS PAC ID: 1153229653 Enrollment ID: I20031230000247 |
| Provider Name | Carl R Gray |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1598873382 PECOS PAC ID: 5092701581 Enrollment ID: I20040421000802 |
| Provider Name | Bradley R Melville |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1407867658 PECOS PAC ID: 8224024765 Enrollment ID: I20040421001176 |
| Provider Name | Michael Hall |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1720075047 PECOS PAC ID: 5193713485 Enrollment ID: I20040505000201 |
| Provider Name | David M Allen |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1487672986 PECOS PAC ID: 9335130020 Enrollment ID: I20040520001568 |
| Provider Name | Laurel Brewer |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1578551693 PECOS PAC ID: 1355327594 Enrollment ID: I20040628000835 |
| Provider Name | Douglas K Anderson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1790898807 PECOS PAC ID: 2264407899 Enrollment ID: I20040831000489 |
| Provider Name | Timothy S Houden |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1255339552 PECOS PAC ID: 8527028513 Enrollment ID: I20041014000095 |
| Provider Name | Alvin K Nichols |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548366347 PECOS PAC ID: 5890755300 Enrollment ID: I20041018001142 |
| Provider Name | Jeffery T Sorensen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1508853425 PECOS PAC ID: 1456395284 Enrollment ID: I20050613001356 |
| Provider Name | Brent M Baranko |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306833967 PECOS PAC ID: 0547151904 Enrollment ID: I20050614000950 |
| Provider Name | Kevin G Walker |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1013905819 PECOS PAC ID: 8729022470 Enrollment ID: I20050614001001 |
| Provider Name | Larry O Smithing |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609864461 PECOS PAC ID: 4284678889 Enrollment ID: I20050614001453 |
| Provider Name | Ruth V Earley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427023597 PECOS PAC ID: 5395727218 Enrollment ID: I20050803000227 |
| Provider Name | Chad M Gonzales |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669447801 PECOS PAC ID: 2264329101 Enrollment ID: I20050812001023 |
| Provider Name | Brian H Morgan |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1598873283 PECOS PAC ID: 5991728594 Enrollment ID: I20060110000574 |
| Provider Name | Douglas T Shepherd |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1659482289 PECOS PAC ID: 6709800956 Enrollment ID: I20060116000167 |
| Provider Name | Darren W Housel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023031507 PECOS PAC ID: 4385675644 Enrollment ID: I20060209000353 |
| Provider Name | Richard Hammond |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174541742 PECOS PAC ID: 4880697606 Enrollment ID: I20060817000223 |
| Provider Name | Rock E Harper |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265578553 PECOS PAC ID: 7416051313 Enrollment ID: I20070403000133 |
| Provider Name | Brett E Richards |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1356470033 PECOS PAC ID: 5496854895 Enrollment ID: I20070626000562 |
| Provider Name | Rohn C Rigby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437283553 PECOS PAC ID: 3173614500 Enrollment ID: I20070814000334 |
| Provider Name | Bryson S Smith |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1669507984 PECOS PAC ID: 9234225848 Enrollment ID: I20071012000180 |
| Provider Name | Loran A Archuleta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770635096 PECOS PAC ID: 7214024447 Enrollment ID: I20071103000163 |
| Provider Name | Dennis D Winters |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1194769604 PECOS PAC ID: 1951499797 Enrollment ID: I20071113000259 |
| Provider Name | Francis X Yubero |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1922010925 PECOS PAC ID: 7315841640 Enrollment ID: I20080408000401 |
| Provider Name | Sheila G Garvey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245227792 PECOS PAC ID: 9032298641 Enrollment ID: I20080508000061 |
| Provider Name | Edward A Jordan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740277599 PECOS PAC ID: 1850470477 Enrollment ID: I20080508000156 |
| Provider Name | Blake G Welling |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1710151980 PECOS PAC ID: 4284703505 Enrollment ID: I20080513000253 |
| Provider Name | Jason Todd Bruse |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1679502710 PECOS PAC ID: 6608947981 Enrollment ID: I20080613000065 |
| Provider Name | Jeffrey L Bell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992869598 PECOS PAC ID: 1759349327 Enrollment ID: I20081007000594 |
| Provider Name | Tyler L Christensen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1811097629 PECOS PAC ID: 0345393427 Enrollment ID: I20090807000090 |
| Provider Name | Layne T Summers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528087848 PECOS PAC ID: 8921136730 Enrollment ID: I20100624000953 |
| Provider Name | Robert Wayment |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1295957280 PECOS PAC ID: 5395878011 Enrollment ID: I20100802000852 |
| Provider Name | Jason Charles Hadley |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1619148129 PECOS PAC ID: 6406980655 Enrollment ID: I20100810000839 |
| Provider Name | Fred George Seale |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518962794 PECOS PAC ID: 9931225075 Enrollment ID: I20100927001027 |
| Provider Name | Jan W Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821171786 PECOS PAC ID: 4587856505 Enrollment ID: I20101008000997 |
| Provider Name | Rebecca Jo Santek |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245396167 PECOS PAC ID: 7911909809 Enrollment ID: I20101011000942 |
| Provider Name | Scott D Swift |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568445807 PECOS PAC ID: 4082641121 Enrollment ID: I20101022000365 |
| Provider Name | Lori K Ramirez |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1508952615 PECOS PAC ID: 2860453727 Enrollment ID: I20101104000856 |
| Provider Name | Robert H Ziegler |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972591790 PECOS PAC ID: 5294922654 Enrollment ID: I20101210000333 |
| Provider Name | Nadim B Bikhazi |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1588651152 PECOS PAC ID: 7517866916 Enrollment ID: I20110104001141 |
| Provider Name | John R Siddoway |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1356338388 PECOS PAC ID: 7810077179 Enrollment ID: I20110106000803 |
| Provider Name | Ryan Parker Mcdonald |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1194915561 PECOS PAC ID: 6709917685 Enrollment ID: I20110225000176 |
| Provider Name | Megan W Grunander |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891987921 PECOS PAC ID: 4082776307 Enrollment ID: I20110718000178 |
| Provider Name | Chad W Tingey |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1043335300 PECOS PAC ID: 3375698830 Enrollment ID: I20110721000083 |
| Provider Name | Adam R Taintor |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1851563779 PECOS PAC ID: 3476724634 Enrollment ID: I20110920000009 |
| Provider Name | Kurt D Bangerter |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1215948799 PECOS PAC ID: 6002998929 Enrollment ID: I20110927000104 |
| Provider Name | Rosemary T Lesser |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407824667 PECOS PAC ID: 4486812294 Enrollment ID: I20120224000764 |
| Provider Name | Megan M Shutts-karjola |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437143351 PECOS PAC ID: 6305094780 Enrollment ID: I20120910000083 |
| Provider Name | Bryan K Wilcox |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1891795779 PECOS PAC ID: 2668460957 Enrollment ID: I20121129000216 |
| Provider Name | Kyle G Dunning |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548453582 PECOS PAC ID: 0547439069 Enrollment ID: I20130816000419 |
| Provider Name | Leigh Jarman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366884306 PECOS PAC ID: 2264675693 Enrollment ID: I20130903000726 |
| Provider Name | Amandeep S Chadha |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1881635845 PECOS PAC ID: 8527024470 Enrollment ID: I20140218000086 |
| Provider Name | Steven D Mayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083897177 PECOS PAC ID: 8022094671 Enrollment ID: I20141027000424 |
| Provider Name | Brett Wayne Martindale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164860573 PECOS PAC ID: 0547586265 Enrollment ID: I20150224000218 |
| Provider Name | Bradford J Stevenson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1710298047 PECOS PAC ID: 4486893450 Enrollment ID: I20150730010824 |
| Provider Name | Mindy K Robert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245630078 PECOS PAC ID: 7618279829 Enrollment ID: I20160105002205 |
| Provider Name | Robyn A Vaughan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932572260 PECOS PAC ID: 9537467758 Enrollment ID: I20160420002186 |
| Provider Name | Joshua G Vandersteen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285959114 PECOS PAC ID: 4284928920 Enrollment ID: I20160803002102 |
| Provider Name | Megan C Walker |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1083976815 PECOS PAC ID: 9830415835 Enrollment ID: I20160823001158 |
| Provider Name | Nancy S Shina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255884037 PECOS PAC ID: 2860770997 Enrollment ID: I20161025001121 |
| Provider Name | Raymond M Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518401397 PECOS PAC ID: 6002198108 Enrollment ID: I20170125002442 |
| Provider Name | Sydney C Piercey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104875855 PECOS PAC ID: 8123142338 Enrollment ID: I20170405000855 |
| Provider Name | Kelli L Loveland |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1346776127 PECOS PAC ID: 7618244658 Enrollment ID: I20170524000033 |
| Provider Name | Trevor Reed Smith |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1700143930 PECOS PAC ID: 9335371459 Enrollment ID: I20170811001913 |
| Provider Name | Stacie P Egan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376062752 PECOS PAC ID: 3870850290 Enrollment ID: I20171120001942 |
| Provider Name | Sheryl A Bingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689181018 PECOS PAC ID: 7113287384 Enrollment ID: I20180207003148 |
| Provider Name | Tyler M Nixon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669639985 PECOS PAC ID: 0143419739 Enrollment ID: I20180417002469 |
| Provider Name | Jeffrey Clay Aucoin |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1265723423 PECOS PAC ID: 1355562869 Enrollment ID: I20180911003692 |
| Provider Name | Britney Bunot |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821423609 PECOS PAC ID: 6002151693 Enrollment ID: I20190102000244 |
| Provider Name | Tania Patricia Nisimblat Bodnar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750520201 PECOS PAC ID: 0749478717 Enrollment ID: I20190110000469 |
| Provider Name | Krystal Milla Somoza |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1639467046 PECOS PAC ID: 2668642547 Enrollment ID: I20190208001653 |
| Provider Name | Eleanore Debbie Weese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588136485 PECOS PAC ID: 5890035877 Enrollment ID: I20190329001473 |
| Provider Name | Chance Colton Buttars |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760973366 PECOS PAC ID: 9931454469 Enrollment ID: I20190711001606 |
| Provider Name | Paige Banks Shelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245614866 PECOS PAC ID: 1759616428 Enrollment ID: I20190717002754 |
| Provider Name | Dennin Loomis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205494242 PECOS PAC ID: 9133456924 Enrollment ID: I20190816002112 |
| Provider Name | Paul Bikhazi |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1427141944 PECOS PAC ID: 9133263718 Enrollment ID: I20191031000780 |
| Provider Name | Christopher Murphy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215900584 PECOS PAC ID: 2365689486 Enrollment ID: I20200127002373 |
| Provider Name | Holly M Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255979191 PECOS PAC ID: 4385074061 Enrollment ID: I20200420003477 |
| Provider Name | Risa Rowley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821622770 PECOS PAC ID: 2264862796 Enrollment ID: I20200423000912 |
| Provider Name | Joshua B Bradshaw |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1619362779 PECOS PAC ID: 0840613469 Enrollment ID: I20200714003633 |
| Provider Name | Austin R Bennion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285249318 PECOS PAC ID: 5395155949 Enrollment ID: I20201110001926 |
| Provider Name | Steven Jonathan Williams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316350135 PECOS PAC ID: 2466724604 Enrollment ID: I20210621002420 |
| Provider Name | Eric E Liedtke |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366624330 PECOS PAC ID: 1153567482 Enrollment ID: I20210622002566 |
| Provider Name | Lynn C Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295058501 PECOS PAC ID: 1052619665 Enrollment ID: I20210727003030 |
| Provider Name | Damian A Illing |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1437536554 PECOS PAC ID: 0547540031 Enrollment ID: I20210728001597 |
| Provider Name | Daniel Joseph Johnson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1356720221 PECOS PAC ID: 4789983529 Enrollment ID: I20210729001642 |
| Provider Name | Lexie Jex |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1083286140 PECOS PAC ID: 6002211976 Enrollment ID: I20210817000305 |
| Provider Name | Maegan Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447834817 PECOS PAC ID: 9739567710 Enrollment ID: I20220602002637 |
| Provider Name | Kari L Loehr |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1518601426 PECOS PAC ID: 5698153369 Enrollment ID: I20220608002318 |
| Provider Name | Jonathan C Conley |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1689318529 PECOS PAC ID: 0547642654 Enrollment ID: I20220806000262 |
| Provider Name | Channa Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306584065 PECOS PAC ID: 3476936790 Enrollment ID: I20220819001231 |
| Provider Name | Melissa Marie Williford |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1184097537 PECOS PAC ID: 5395115570 Enrollment ID: I20230104001385 |
| Provider Name | Stephanie R Nainani |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326056573 PECOS PAC ID: 4284638586 Enrollment ID: I20230120000527 |
| Provider Name | Alisa Porter Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427789064 PECOS PAC ID: 2264806413 Enrollment ID: I20230330000068 |
| Provider Name | Joshua G Ramsay |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1093245607 PECOS PAC ID: 7416227574 Enrollment ID: I20230703002079 |
| Provider Name | Jason R Lucas |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1790312072 PECOS PAC ID: 1153744271 Enrollment ID: I20230718001995 |
| Provider Name | Cara V Munson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1770956534 PECOS PAC ID: 1951730852 Enrollment ID: I20230908002907 |
| Provider Name | Heather E Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306429311 PECOS PAC ID: 0345696233 Enrollment ID: I20231030000988 |
Ogden Internal Medicine & Urology Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5405 S 500 E Ste 203, Ogden, UT 84405 Phone: 801-475-8600 Fax: 801-475-8686 | |
Ihc Health Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4421 Harrison Blvd Ste A12, Ogden, UT 84403 Phone: 801-442-1853 | |
Blaser Medical Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3500 Harrison Blvd Ste 200, Ogden, UT 84403 Phone: 801-515-7997 Fax: 385-333-7413 | |
Mckay Dee Endocrine And Diabetes Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4403 Harrison Blvd, Ste 3630, Ogden, UT 84403 Phone: 801-387-7901 | |
Weber State University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 University Cir, Ogden, UT 84408 Phone: 972-367-4845 Fax: 972-367-3451 | |
Ogden Womens Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4403 Harrison Blvd, Suite 4650, Ogden, UT 84403 Phone: 801-387-4400 | |
Walter E Brodis Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1893 E Skyline Dr, Ogden, UT 84403 Phone: 801-721-4587 |