| Jordan Ridge Family Medicine LLC | |
|
4071 S 4000 W West Valley City UT 84120-4143 | |
| (801) 515-7196 | |
| Not Available |
| Full Name | Jordan Ridge Family Medicine LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 4071 S 4000 W, West Valley City, Utah |
| Authorized Official Name and Position | John Rhodes (MD) |
| Authorized Official Contact | 7024802550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Ridge Family Medicine LLC Po Box 35380 Las Vegas NV 89133-5380 Ph: (702) 560-2916 | Jordan Ridge Family Medicine LLC 4071 S 4000 W West Valley City UT 84120-4143 Ph: (801) 515-7196 |
| NPI Number | 1306275227 |
|---|---|
| Provider Enumeration Date | 11/02/2013 |
| Last Update Date | 08/09/2023 |
| Certification Date | 08/09/2023 |
| Medicare PECOS PAC ID | 7214168111 |
|---|---|
| Medicare Enrollment ID | O20201221001430 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306275227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 207R00000X | Internal Medicine | () | Secondary |
| Provider Name | Diane Kendall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659397545 PECOS PAC ID: 5294730552 Enrollment ID: I20060921000049 |
| Provider Name | Bryan William Lundberg |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619398021 PECOS PAC ID: 3173753233 Enrollment ID: I20140311001533 |
| Provider Name | Jennifer Beyer Jenkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891125100 PECOS PAC ID: 6204066756 Enrollment ID: I20140312001244 |
| Provider Name | Jennifer Mooney |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841692233 PECOS PAC ID: 0749508844 Enrollment ID: I20150422001165 |
| Provider Name | Natalie Lois Jensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477085090 PECOS PAC ID: 0547531709 Enrollment ID: I20170807000291 |
| Provider Name | Karen Bohn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528533775 PECOS PAC ID: 9638415581 Enrollment ID: I20190114001589 |
| Provider Name | Steven G Richardson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629030838 PECOS PAC ID: 6406877000 Enrollment ID: I20210107002513 |
| Provider Name | Kristen Carrier |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1861764268 PECOS PAC ID: 6204097124 Enrollment ID: I20210806002966 |
| Provider Name | Tia Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841675576 PECOS PAC ID: 9436465382 Enrollment ID: I20221017003299 |
Vamos Health UT Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3725 W 4100 S Ste 107, West Valley City, UT 84120 Phone: 502-333-2281 |
Molina Medical Group of Southern California Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2196 West 3500 South, Suite C1, West Valley City, UT 84119 Phone: 562-499-6191 Fax: 562-499-6171 |
Granite Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4163 S 3200 W, West Valley City, UT 84119 Phone: 801-964-9355 Fax: 801-967-2692 |
3 Form - West Valley City Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2300 S 2300 W Ste B, West Valley City, UT 84119 Phone: 801-975-7505 |
Gastroenterology West Valley Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3336 S 4155 W, Ste 306, West Valley City, UT 84120 Phone: 901-964-3855 Fax: 801-208-6367 |
West Valley Specialty Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5373 W Lake Park Blvd, West Valley City, UT 84127 Phone: 801-442-1853 |