| Tooele Clinic Corp | |
|
1887 Aaron Dr Ste B Tooele UT 84074-8138 | |
| (435) 775-9973 | |
| (435) 775-9985 |
| Full Name | Tooele Clinic Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 1887 Aaron Dr Ste B, Tooele, Utah |
| Authorized Official Name and Position | Laura J Fey (SR. DIRECTOR PHYSICIAN REV CYCLE) |
| Authorized Official Contact | 6152213641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tooele Clinic Corp Po Box 5009 Brentwood TN 37024-5009 Ph: (615) 221-1400 | Tooele Clinic Corp 1887 Aaron Dr Ste B Tooele UT 84074-8138 Ph: (435) 775-9973 |
| NPI Number | 1073512364 |
|---|---|
| Provider Enumeration Date | 07/19/2005 |
| Last Update Date | 07/07/2023 |
| Medicare PECOS PAC ID | 6800700873 |
|---|---|
| Medicare Enrollment ID | O20031113000800 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073512364 | NPI | - | NPPES |
| 1073512364 | Medicaid | UT |
| Provider Name | Kevin John Whitehead |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255421848 PECOS PAC ID: 9032004502 Enrollment ID: I20040216000590 |
| Provider Name | Edward M Gilbert |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003903923 PECOS PAC ID: 2365434669 Enrollment ID: I20040330000512 |
| Provider Name | Bruce Bray |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124118708 PECOS PAC ID: 9739175407 Enrollment ID: I20040427001450 |
| Provider Name | Roger A Freedman |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1790866580 PECOS PAC ID: 7416841697 Enrollment ID: I20040429000579 |
| Provider Name | Curtis R Dustin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821043548 PECOS PAC ID: 1759359326 Enrollment ID: I20040921001066 |
| Provider Name | Ronald R Trudel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962455626 PECOS PAC ID: 5193793784 Enrollment ID: I20040921001187 |
| Provider Name | Benjamin J Krogh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013003540 PECOS PAC ID: 9234192055 Enrollment ID: I20041111000575 |
| Provider Name | Gary D Snook |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295755924 PECOS PAC ID: 6406747377 Enrollment ID: I20050105000189 |
| Provider Name | Brent Lee Clyde |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1700896552 PECOS PAC ID: 6103724679 Enrollment ID: I20050823000109 |
| Provider Name | Blaine J Cashmore |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174576144 PECOS PAC ID: 5395760813 Enrollment ID: I20051013000130 |
| Provider Name | Brent Donald Wilson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831121938 PECOS PAC ID: 3971516303 Enrollment ID: I20060801000124 |
| Provider Name | Raminder Nirula |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1497707178 PECOS PAC ID: 5395733745 Enrollment ID: I20071015000413 |
| Provider Name | Thomas Jared Bunch |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1790757516 PECOS PAC ID: 3173601051 Enrollment ID: I20081114000177 |
| Provider Name | Jack Hojjat Morshedzadeh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1447381447 PECOS PAC ID: 1850446220 Enrollment ID: I20090908000692 |
| Provider Name | Christine E Oberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770693830 PECOS PAC ID: 6507894086 Enrollment ID: I20090917000201 |
| Provider Name | Rebekah R Aldridge |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427386770 PECOS PAC ID: 6800930264 Enrollment ID: I20100223000490 |
| Provider Name | Scott A Hopkins |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1649310681 PECOS PAC ID: 4789644568 Enrollment ID: I20100715000910 |
| Provider Name | Charles Edward Holt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689772519 PECOS PAC ID: 3072647296 Enrollment ID: I20100810000552 |
| Provider Name | Lillian Khor |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1851403836 PECOS PAC ID: 5698968808 Enrollment ID: I20101020001063 |
| Provider Name | Alma L Parker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164474037 PECOS PAC ID: 1456263623 Enrollment ID: I20110616000611 |
| Provider Name | Russell Steven Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548407513 PECOS PAC ID: 6103094008 Enrollment ID: I20110720000404 |
| Provider Name | Samara O Lazernick |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659532307 PECOS PAC ID: 6103073515 Enrollment ID: I20120820000910 |
| 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 | Brigham Ronald Smith |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1558557322 PECOS PAC ID: 9537319579 Enrollment ID: I20121026000742 |
| Provider Name | John Joseph Ryan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902071673 PECOS PAC ID: 7113162033 Enrollment ID: I20130326000164 |
| Provider Name | Devin J Horton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629396924 PECOS PAC ID: 2264672526 Enrollment ID: I20130709000756 |
| Provider Name | Steven Rich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902118714 PECOS PAC ID: 1456593490 Enrollment ID: I20130805000229 |
| Provider Name | David A Bowman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053486076 PECOS PAC ID: 7214832955 Enrollment ID: I20130820000355 |
| Provider Name | Jeffrey L Carlson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1609027689 PECOS PAC ID: 0446434518 Enrollment ID: I20140805002268 |
| Provider Name | Levi Bachler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134199227 PECOS PAC ID: 2961496641 Enrollment ID: I20140812001209 |
| Provider Name | Rashmee U Shah |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215184510 PECOS PAC ID: 7810038353 Enrollment ID: I20140912000302 |
| Provider Name | Jacob Woodruff Daynes |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1528220753 PECOS PAC ID: 8325260003 Enrollment ID: I20141113000391 |
| Provider Name | Omar E Wever-pinzon |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205926250 PECOS PAC ID: 6002902905 Enrollment ID: I20150902001588 |
| Provider Name | Sandra Spackman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164892592 PECOS PAC ID: 0749580009 Enrollment ID: I20151118002680 |
| Provider Name | Dipayan Chaudhuri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982872370 PECOS PAC ID: 6002073889 Enrollment ID: I20160127001240 |
| Provider Name | Catherine Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245510627 PECOS PAC ID: 4486951456 Enrollment ID: I20160318001753 |
| Provider Name | Scott Stern |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770525826 PECOS PAC ID: 3072556802 Enrollment ID: I20160620001684 |
| Provider Name | Benjamin A Steinberg |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1407065188 PECOS PAC ID: 6406149426 Enrollment ID: I20160727002348 |
| Provider Name | Juneyoung L Chavez |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1376778639 PECOS PAC ID: 9739479957 Enrollment ID: I20160816000554 |
| Provider Name | Rodney Barker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023178530 PECOS PAC ID: 4486626348 Enrollment ID: I20161006001594 |
| Provider Name | Clint Allred |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609190172 PECOS PAC ID: 6103067467 Enrollment ID: I20170703001539 |
| Provider Name | Russell Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982148581 PECOS PAC ID: 0648549329 Enrollment ID: I20170712001664 |
| Provider Name | Gordon Dale Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205356250 PECOS PAC ID: 2264791870 Enrollment ID: I20180104001523 |
| Provider Name | Majd Ibrahim |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700199627 PECOS PAC ID: 9133440464 Enrollment ID: I20180530001062 |
| Provider Name | Meena M Aserlind |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619395332 PECOS PAC ID: 1557619251 Enrollment ID: I20180810002513 |
| Provider Name | Leenhapong Navaravong |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1396937363 PECOS PAC ID: 3779715859 Enrollment ID: I20190603001417 |
| Provider Name | Jessica Ivanka Treidl Chan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275920373 PECOS PAC ID: 7810290830 Enrollment ID: I20190607000906 |
| Provider Name | Eric C Tuday |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386903847 PECOS PAC ID: 2567609787 Enrollment ID: I20190708001398 |
| Provider Name | Jared Huber |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699138792 PECOS PAC ID: 5496041543 Enrollment ID: I20190726001329 |
| Provider Name | Kevin Shah |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861757544 PECOS PAC ID: 8628307501 Enrollment ID: I20190903002630 |
| Provider Name | Zara Zeni Mahamat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801458328 PECOS PAC ID: 3870822984 Enrollment ID: I20190913001872 |
| Provider Name | Mike H Rady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346882859 PECOS PAC ID: 8325473911 Enrollment ID: I20200108002311 |
| Provider Name | Tara Louise Jones |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1821352816 PECOS PAC ID: 8325261142 Enrollment ID: I20200517000002 |
| Provider Name | Marja Eleni Anton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548623838 PECOS PAC ID: 3971879404 Enrollment ID: I20200610002967 |
| Provider Name | China G Cox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538690862 PECOS PAC ID: 3870846421 Enrollment ID: I20200612000872 |
| Provider Name | Luke A Martin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659637502 PECOS PAC ID: 5395977995 Enrollment ID: I20200629000936 |
| Provider Name | Joanna S Grudziak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538421920 PECOS PAC ID: 8921395385 Enrollment ID: I20200629002395 |
| Provider Name | Jennwood Chen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649615980 PECOS PAC ID: 8820311129 Enrollment ID: I20200702001135 |
| Provider Name | Christopher Andrew Groh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396008678 PECOS PAC ID: 0446542674 Enrollment ID: I20200702001287 |
| Provider Name | Alexia Rae Searle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962029611 PECOS PAC ID: 0749605715 Enrollment ID: I20200807001214 |
| Provider Name | Lacey A Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639796477 PECOS PAC ID: 5294152047 Enrollment ID: I20200825003685 |
| Provider Name | Sarah Lombardo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972862894 PECOS PAC ID: 5597997205 Enrollment ID: I20200909001179 |
| Provider Name | Gordon Duval |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619383304 PECOS PAC ID: 3274857099 Enrollment ID: I20200913000018 |
| Provider Name | Samuel John Kozloff |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821521337 PECOS PAC ID: 2668707175 Enrollment ID: I20201118003130 |
| Provider Name | Breann Nicole Banford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568908929 PECOS PAC ID: 8527471721 Enrollment ID: I20210107001541 |
| Provider Name | Sarah Eastman Norton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205369642 PECOS PAC ID: 8224443940 Enrollment ID: I20210210002176 |
| Provider Name | Anees Daud |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134547623 PECOS PAC ID: 5294043956 Enrollment ID: I20210405001620 |
| Provider Name | David Zobell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598374357 PECOS PAC ID: 2062811862 Enrollment ID: I20210527002290 |
| Provider Name | Craig Arthur Penton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780037077 PECOS PAC ID: 7416359757 Enrollment ID: I20210709000746 |
| Provider Name | Kristin Dawn Harko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457924433 PECOS PAC ID: 7113325549 Enrollment ID: I20211014002664 |
| Provider Name | Julee Kimball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134890510 PECOS PAC ID: 6800285099 Enrollment ID: I20211109002045 |
| Provider Name | Anthony Mowrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740259753 PECOS PAC ID: 0547216996 Enrollment ID: I20211124001318 |
| Provider Name | Roxanne J Weiss |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053842609 PECOS PAC ID: 8022361443 Enrollment ID: I20220607002177 |
| Provider Name | Trenton C Fuller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770045197 PECOS PAC ID: 3476971953 Enrollment ID: I20220609000221 |
| Provider Name | Viveca E Falks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760126825 PECOS PAC ID: 1759769268 Enrollment ID: I20220610002155 |
| Provider Name | Isadore D. Dodard-friedman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699235069 PECOS PAC ID: 4688092372 Enrollment ID: I20220613000985 |
| Provider Name | Scott F Schoninger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235793001 PECOS PAC ID: 1456684992 Enrollment ID: I20220830000231 |
| Provider Name | Julie Frances Weis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609338987 PECOS PAC ID: 1153656624 Enrollment ID: I20220916002635 |
| Provider Name | Austin King Fackler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437871514 PECOS PAC ID: 3072982578 Enrollment ID: I20221205002547 |
| Provider Name | Crystal Anne Ruby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104522853 PECOS PAC ID: 3173996311 Enrollment ID: I20230308002557 |
| Provider Name | Slade Alan Hodges |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073756888 PECOS PAC ID: 5698924330 Enrollment ID: I20230310001152 |
| Provider Name | Emily B Worrall |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922627207 PECOS PAC ID: 0547685216 Enrollment ID: I20230720002247 |
| Provider Name | George Lolay |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811333941 PECOS PAC ID: 1052626090 Enrollment ID: I20231027001407 |
Valley Family Medicine Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2376 N 400 E Ste 102, Tooele, UT 84074 Phone: 435-843-1225 Fax: 435-843-1228 | |
Oasis Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1929 Aaron Dr, Suite I, Tooele, UT 84074 Phone: 435-833-0229 Fax: 435-833-0231 | |
Spine And Posture Rehabilitation Of Tooele Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 S Main St, Suite 2, Tooele, UT 84074 Phone: 435-882-1621 Fax: 435-882-8267 | |
Granger Medical Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2356 N 400 E Ste 201, Tooele, UT 84074 Phone: 801-352-5900 Fax: 801-352-5914 | |
Ram C Sharma, Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 255 S 100 E, Tooele, UT 84074 Phone: 435-882-0424 Fax: 435-843-1511 | |
Blake R. Beazer, M.d., Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2356 N 400 E, Ste. 201, Tooele, UT 84074 Phone: 435-882-2350 Fax: 435-882-2039 |