| Physicians Of Advance Sports & Orthopedic Medicine | |
|
3401 N Center St Ste 100 Lehi UT 84043-7497 | |
| (801) 400-7307 | |
| Not Available |
| Full Name | Physicians Of Advance Sports & Orthopedic Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 3401 N Center St, Lehi, Utah |
| Authorized Official Name and Position | Curtis A Nielsen (PARTNER) |
| Authorized Official Contact | 8017537770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physicians Of Advance Sports & Orthopedic Medicine 3401 N Center St Ste 100 Lehi UT 84043-7498 Ph: (801) 753-7770 | Physicians Of Advance Sports & Orthopedic Medicine 3401 N Center St Ste 100 Lehi UT 84043-7497 Ph: (801) 400-7307 |
| NPI Number | 1285013987 |
|---|---|
| Provider Enumeration Date | 05/27/2015 |
| Last Update Date | 03/03/2021 |
| Medicare PECOS PAC ID | 6204140122 |
|---|---|
| Medicare Enrollment ID | O20150805007176 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285013987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Curtis A Nielsen |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1013237502 PECOS PAC ID: 9739330523 Enrollment ID: I20130611000491 |
| Provider Name | Cory Dee Nelson |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1124339460 PECOS PAC ID: 0446499206 Enrollment ID: I20130627000097 |
| Provider Name | Jason David Brill |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1467831966 PECOS PAC ID: 1153618285 Enrollment ID: I20160916002315 |
| Provider Name | Kellen Tage Hansen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396007316 PECOS PAC ID: 6204071657 Enrollment ID: I20170630001472 |
| Provider Name | Judd Charles Allen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1639463714 PECOS PAC ID: 8921308735 Enrollment ID: I20180808002078 |
| Provider Name | Mark Edward Sederberg |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1255793576 PECOS PAC ID: 2769778737 Enrollment ID: I20200612000595 |
| Provider Name | Gary Robert Edwards |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922425800 PECOS PAC ID: 1456661800 Enrollment ID: I20201013001501 |
| Provider Name | Nicholas Joseph Sacksteder |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295149821 PECOS PAC ID: 1456654862 Enrollment ID: I20230830001983 |
| Provider Name | Caleb M West |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1649705880 PECOS PAC ID: 9032536511 Enrollment ID: I20230906003271 |
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