DR. SANDRA W BAGLEY (NPI# 1023022415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023022415 |
| Entity Type | Individual |
| Full Name | DR. SANDRA W BAGLEY |
| Credential | APRN PHD MSW |
| Practice Address |
3683 Wilde Rose Lane Salt Lake City UT 84109 |
| Practice Telephone | 8012730295 |
| Mailing Telephone | 8012730295 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2013-03-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | 1166903502 | UT | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 1166903902 | UT | Behavioral Health & Social Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1166904405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | PTAN | U000075209 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568781516 | Sandra Allmond Bagley | Speech-Language Pathologist | 502 Oak St, Blackstone, VA 23824-2222 | 2010-05-28 |
| 1447611710 | Sandra Bagley | Dental Hygienist | 1532 Galena St, Ste 380, Aurora, CO 80010-2287 | 2016-03-15 |
| Street Address |
3683 WILDE ROSE LANE |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102095 | Aimee Hadfield | Social Worker | Hearten House, 314 W. Broadway #222, Salt Lake City, UT 84109 | 2020-07-23 |
| 1245877448 | Carla Lucile Applegate-anderson | Nurse Practitioner | 2666 South 2000 East, Suite 101, Salt Lake City, UT 84109 | 2019-12-06 |
| 1063991982 | Madison Sanderson | Physical Therapist | 2295 S Foothill Dr Ste 1, Salt Lake City, UT 84109 | 2018-08-10 |
| 1023545951 | Tyler Dale Hanks | Dentist | 2435 E 3300 S, Suite 101, Millcreek, UT 84109 | 2017-05-23 |
| 1992198881 | Cynthia R Thorpe | Marriage & Family Therapist | 2624 East Mount Crest Drive, Salt Lake City, UT 84109 | 2015-03-17 |
| 1104247295 | John Paul Lapine | Dentist | 3865 South 3500 East Ste. 201, Salt Lake City, UT 84109 | 2013-12-17 |
| 1073850301 | Weston J Horne | Massage Therapist | 2760 South 1174 East, Suite 1d, Salt Lake City, UT 84109 | 2013-01-07 |
| 1538415138 | Dominic Falsone | Counselor | 3846 Villa Dr, Salt Lake City, UT 84109 | 2012-08-01 |
| 1487926341 | Richard R Flynn | Pediatrics | 2342 Dallin St., Salt Lake City, UT 84109 | 2012-02-07 |
| 1235449984 | Keyhan Koohgivi | Pharmacist | 2566 East Sage Way, Salt Lake City, UT 84109 | 2010-10-15 |
| Find all providers in zip 84109 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204590 | Gabrielle Sleater Lewis | Nurse Practitioner | 2905 S Mcclelland St, Salt Lake City, UT 84106-2125 | 2020-11-01 |
| 1962019596 | Freya Kristen Landesman | Nurse Practitioner | 60 E South Temple Ste 300, Salt Lake City, UT 84111-1041 | 2020-09-28 |
| 1568075604 | Michelle L Davis | Nurse Practitioner | 24 S 1100 E Ste 305, Salt Lake City, UT 84102-4500 | 2020-08-28 |
| 1518583988 | Melanie Elise Harris | Nurse Practitioner | 1250 E 3900 S Ste 301, Salt Lake City, UT 84124-1350 | 2020-06-22 |
| 1295359651 | Julie Nielsen | Nurse Practitioner | 1170 E Westminster Ave Apt C, Salt Lake City, UT 84105-3514 | 2020-06-02 |
| 1770112138 | Justin Henderson | Nurse Practitioner | 3851 S Birch Dr, Salt Lake City, UT 84109-3742 | 2020-04-07 |
| 1346885845 | Anita Hui Lucente | Nurse Practitioner | 1111 E Brickyard Rd, Salt Lake City, UT 84106-2560 | 2019-11-08 |
| 1841844057 | Mayra Ibeth Vences | Nurse Practitioner | 1146 N Antilles Dr, Salt Lake City, UT 84116-4656 | 2019-07-25 |
| 1710549928 | Jenny Farley Mason | Nurse Practitioner | 4179 S Monarch Way, Salt Lake City, UT 84124-3168 | 2019-07-08 |
| 1144889940 | Amy Jackson Gilbert | Nurse Practitioner | 1950 Circle of Hope Dr Rm 4146, Salt Lake City, UT 84112-5500 | 2019-06-06 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84109 |
Please comment or provide details below to improve the information on DR. SANDRA W BAGLEY.
| 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.