PURE LIFE PTG (NPI# 1003323767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003323767 |
| Entity Type | Organization |
| Organization Name | PURE LIFE PTG |
| Practice Address |
7390 S Creek Rd Ste 202 Sandy UT 84093-6123 |
| Mailing Address |
14218 S Canyon Vine Cv Draper UT 84020-5631 |
| Practice Telephone | 8018932550 |
| Mailing Telephone | 8018789597 |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2018-01-03 |
| Authorized Official Name | JOHN LUND (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8016643741 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
7390 S CREEK RD STE 202 |
| City | SANDY |
| State | UT |
| Zip Code | 84093-6123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942830674 | Maren Vanwagoner Ferre | Nurse Practitioner | 1455 E Quail Stream Ln, Cottonwood Heights, UT 84093 | 2020-01-22 |
| 1154820041 | Cassandra Bringhurst | Music Therapist | 8261 S Viscounti Dr., Sandy, UT 84093 | 2018-02-06 |
| 1518480540 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 8645 S Highland Dr, Sandy, UT 84093 | 2017-07-21 |
| 1457881955 | Valor Psychological Services, LLC | Psychologist | 8160 S Highland Dr Ste C104, Sandy, UT 84093 | 2017-06-16 |
| 1700279197 | Russell G. Lewis | Dentist | 1434 E. 9400 S. Ste 201, Sandy, UT 84093 | 2015-03-10 |
| 1568771350 | Susan Lynn Nikola | Pharmacist | 8745 S. Highland Dr, Sandy, UT 84093 | 2010-09-28 |
| 1659696227 | Pamela Elizabeth Boyleston | Nurse Anesthetist, Certified Registered | 2628 Partridge Way, Sandy, UT 84093 | 2010-04-07 |
| 1700025582 | Kirk Madson Neuberger | Surgery | 9181 Wedgefield Dr., Sandy, UT 84093 | 2009-02-18 |
| 1326230392 | Sunrie Sandy Senior Living LLC | Assisted Living Facility | 2101 E 9400 S, Sandy, TN 84093 | 2007-08-14 |
| 1497870588 | Chandra Lee Roberson | Counselor | 8188 So. Highland Drive, Suite D-4, Sandy, UT 84093 | 2007-03-20 |
| Find all providers in zip 84093 | ||||
| Taxonomy Code | 103TA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508211285 | Andrea Lindsay-shaffer | Psychologist | 1630 E Edgecliff Dr, Sandy, UT 84092-4309 | 2016-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972151033 | Casadee Yvonne Hudson | Psychologist | 2600 N Main St Ste 200, North Logan, UT 84341-1510 | 2019-08-30 |
| 1962054775 | Kenneth Newell | Psychologist | 640 S 1200 W, Orem, UT 84058-5972 | 2019-07-11 |
| 1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
| 1265899009 | Silver Peak Medical LLC | Psychologist | 1817 S Main St Ste 8, Salt Lake City, UT 84115-7060 | 2016-01-25 |
| 1770502379 | Mark D. Worthen | Psychologist | 1182 Center Dr Ste D160, Park City, UT 84098-1287 | 2006-07-18 |
| 1134586654 | Randy K Moss | Psychologist | 447 N 300 W, Kaysville, UT 84037-4203 | 2016-01-28 |
| 1417321803 | Brighton Medical Group | Psychologist | 1275 E Fort Union Blvd, Suite 202, Cottonwood Heights, UT 84047-1895 | 2015-11-23 |
| 1346670221 | Sadie Alexandra Young | Psychologist | 344 East 100 South, Ste 301, Salt Lake City, UT 84111 | 2013-11-14 |
| 1194070276 | University of Utah | Psychologist | 450 S 900 E, Suite 300, Salt Lake City, UT 84102-2981 | 2012-07-16 |
| 1912048323 | Robert J Courtney Jr. | Psychologist | 30 N 1900 E, 1r52 Som, Salt Lake City, UT 84132-2119 | 2007-02-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.