UTAH PODIATRY GROUP PC (NPI# 1023404514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023404514 |
| Entity Type | Organization |
| Organization Name | UTAH PODIATRY GROUP PC |
| Other Organization Name | ADVANCED FOOT & ANKLE CENTER |
| Practice Address |
191 Overthrust Rd Evanston WY 82930-9261 |
| Mailing Address |
Po Box 540610 N Salt Lake UT 84054-0610 |
| Practice Telephone | 3077890839 |
| Practice Fax Number | 8012749064 |
| Mailing Telephone | 8015055277 |
| Mailing Fax Number | 8015055280 |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2015-04-10 |
| Authorized Official Name | DR. SCOTT A CLARK (OWNER) |
| Authorized Official Telephone | 8015055277 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | Y |
| Parent Organization Name | UTAH PODIATRY GROUP PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
| Other Name | Type Code |
|---|---|
| Advanced Foot & Ankle Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700369014 | Utah Podiatry Group PC | Podiatrist | 6321 S Redwood Rd Ste 102, Taylorsville, UT 84123-6799 | 2018-09-12 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| 1972875524 | Utah Podiatry Group PC | Podiatrist | 2159 S 700 E Ste 150, Salt Lake City, UT 84106 | 2012-01-29 |
| 1659991438 | Utah Podiatry Group PC | Podiatrist | 3435 E Pony Express Pkwy Ste 140, Eagle Mountain, UT 84005-5548 | 2020-04-21 |
| 1942733415 | Utah Podiatry Group PC | Podiatrist | 345 W 600 S, Ste 408, Heber City, UT 84032-2247 | 2017-04-11 |
| 1598205494 | Utah Podiatry Group PC | Podiatrist | 440 Medical Dr, Ste 1, Bountiful, UT 84010-4950 | 2017-02-27 |
| 1831575760 | Utah Podiatry Group PC | Podiatrist | 48 W 1500 N, Nephi, UT 84648-8900 | 2015-08-03 |
| 1457737579 | Utah Podiatry Group PC | Podiatrist | 1973 North State Street, Provo, UT 84604-1012 | 2015-07-31 |
| 1093081101 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E, Suite 301, Salt Lake City, UT 84102 | 2012-03-23 |
| Street Address |
191 OVERTHRUST RD |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930-9261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407832728 | Jason P Haack | Otolaryngology | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2005-12-19 |
| 1669947610 | Stacy Jo Kennedy | Nurse Practitioner | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2018-10-05 |
| 1194226266 | High Desert Psychology and Wellness | Clinic/Center | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2018-02-23 |
| 1790172807 | Uinta Health Lab, LLC | Clinical Medical Laboratory | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2015-04-16 |
| 1962804443 | Barker Family Health, LLC | Nurse Practitioner | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2014-09-16 |
| 1790067999 | Corrie Carver | Nurse Practitioner | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2011-09-13 |
| 1730335423 | Southwest Wyoming Ent Inc | Otolaryngology | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2008-08-13 |
| 1255476131 | Adam K Fuller | Psychologist | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2007-02-20 |
| 1144328949 | Jared Breck Barton | Surgery | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398935 | Colby Kim Gomez | Physical Therapist | 190 Arrowhead Dr, Evanston, Wy 82930, Evanston, WY 82930 | 2020-02-13 |
| 1164808382 | Marilyn Carol Edgeworth Tacoma | Registered Nurse | 1037 Morse Lee St, Evanston, WY 82930 | 2015-08-11 |
| 1699159723 | Impact Physical Therapy LLC | Clinic/Center | 96 Yellow Creek Road, Evanston, WY 82930 | 2015-07-18 |
| 1578942421 | Mark Carstensen | Case Manager/Care Coordinator | 219 7th Street, Evanston, WY 82930 | 2015-05-26 |
| 1013396241 | Jennifer Carstensen | Case Manager/Care Coordinator | 325 Arrowhead Drive, Evanston, WY 82930 | 2015-05-20 |
| 1780083782 | Christa Lena Barker | Nurse Practitioner | 191 Overthrust Road, Evanston, WY 82930 | 2014-08-15 |
| 1366865339 | Don Mckay Francom | Dentist | 170 Arrowhead Dr. Suite 1, Evanston, WY 82930 | 2014-01-28 |
| 1417228370 | Premier Surgical Center, LLC | Clinic/Center | 195 Overthrust Road, Evanston, WY 82930 | 2012-01-24 |
| 1588959324 | Mejia D Williams | Social Worker | 190 Overthrust Road, Evanston, WY 82930 | 2011-06-09 |
| 1225327000 | Richard Jay Capener | Family Medicine | 196 Arrowhead Dr Ste 1, Evanston, WY 82930 | 2011-04-01 |
| Find all providers in zip 82930 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427411669 | Samantha Lauren Jensen | Podiatrist | 2809 Garrison Ave, Evanston, IL 60201-1775 | 2016-04-04 |
| 1780050195 | Zubair Ali Khan | Podiatrist | 2500 Ridge Ave Ste 110, Evanston, IL 60201 | 2015-08-19 |
| 1700060902 | Evanston Family Foot Care | Podiatrist | 1565 Highway 150 South, Suite C, Evanston, WY 82930-5348 | 2007-12-24 |
| 1265877849 | Samantha Dolph Winerman | Podiatrist | 2500 Ridge Ave, Ste 110, Evanston, IL 60201-2455 | 2013-05-08 |
| 1033481627 | Kari Leann Chase | Podiatrist | 2500 Ridge Ave, Suite #110, Evanston, IL 60201-2455 | 2012-01-30 |
| 1477820280 | Chicago Foot and Ankle, LLC | Podiatrist | 355 Ridge Ave, Proffesional Building West Tower, Suite 604, Evanston, IL 60202-3328 | 2011-11-22 |
| 1467676536 | Aaa Foot & Ankle Associates | Podiatrist | 800 Austin St, Suite#469, Evanston, IL 60202-3439 | 2007-04-12 |
| 1205885274 | Kevin John Tunnat | Podiatrist | 800 Austin St, Suite #611, Evanston, IL 60202-3439 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801286778 | Five Star Feet, LLC | Podiatrist | 2525 Road 218, Cheyenne, WY 82009-9103 | 2015-01-30 |
| 1992820781 | Rick B Roper | Podiatrist | 2029 Bluegrass Circle, Suite 2, Cheyenne, WY 82009-7369 | 2007-03-20 |
| 1518037043 | Eric M Dash | Podiatrist | 1916 E 1st St, Suite 1, Casper, WY 82601-2777 | 2006-11-09 |
| 1760824502 | Advanced Foot Care | Podiatrist | 1303 E Grand Ave, Laramie, WY 82070-4137 | 2013-07-22 |
| 1568710598 | The Foot Clinic LLC | Podiatrist | 1916 E 1st St, Casper, WY 82601-2777 | 2012-08-23 |
| 1639459068 | Jason K Kane | Podiatrist | 132 N Gould St, Sheridan, WY 82801-3928 | 2011-08-17 |
| 1003050253 | Big Horn Foot Clinic, PC | Podiatrist | 424 Yellowstone Ave, Suite 140, Cody, WY 82414-9318 | 2009-04-30 |
| 1922241181 | Lael J. Beachler | Podiatrist | 777 Avenue H, Powell, WY 82435-2260 | 2009-04-16 |
| 1912057290 | Aaron Deane Donaldson | Podiatrist | 1005 College View Dr, Riverton, WY 82501-2266 | 2007-01-11 |
| 1497857262 | Tyler Ann Marshall | Podiatrist | 2360 E Pershing Blvd, Cheyenne, WY 82010-0001 | 2006-09-02 |
| 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.