INTEGRATED MEDICAL SERVICES (NPI# 1114289980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114289980 |
| Entity Type | Organization |
| Organization Name | INTEGRATED MEDICAL SERVICES |
| Other Organization Name | INTERMOUNTAIN SENIOR CARE, LLC |
| Practice Address |
630 S. 400 E #101 St George UT 84770 |
| Mailing Address |
616 S. River Rd #200 Po Box 910855 St George UT 84790-2105 |
| Practice Telephone | 4356739653 |
| Practice Fax Number | 4356739008 |
| Mailing Telephone | 4356288944 |
| Mailing Fax Number | 4356354506 |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2020-04-20 |
| Authorized Official Name | CLIFF HOLT (OWNER) |
| Authorized Official Telephone | 4356288944 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Intermountain Senior Care, LLC | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346789872 | Integrated Medical Services | Clinic/Center | 630 S 400 E, 101, St George, UT 84770-3765 | 2017-02-16 |
| 1518402650 | Integrated Medical Services | Exclusive Provider Organization | 111 W Cedar Ln, Payson, AZ 85541-5417 | 2016-12-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | INTEGRATED MEDICAL SERVICES INC. | 6109 D Arlington Blvd, Falls Church, Virginia 22044 |
| Street Address |
630 S. 400 E #101 |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84770 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740808500 | Redstone Reference Laboratories Inc | Clinical Medical Laboratory | 556 N Dixie Drive, Suite 2, St George, UT 84770 | 2020-07-08 |
| 1033776315 | Ecko Ashmore | Marriage & Family Therapist | 1173 S. 250 W. Bld 1 Ste 208, St. George, UT 84770 | 2019-05-22 |
| 1740844679 | Amy Darragh | Behavior Technician | 249 E Tabernacle St, Ste 100, St George, UT 84770 | 2019-04-25 |
| 1124598198 | Loren Kyle Gulbranson | Internal Medicine | Dixie Regional Medical Center, 515 South, 300 East, Saint George, UT 84770 | 2018-12-03 |
| 1487150728 | Sound Sleep Medical LLC | Durable Medical Equipment & Medical Supplies | 640 East 700 South Building 2, St. George, UT 84770 | 2018-04-04 |
| 1588162911 | Desert Edge Medical | Family Medicine | 1664 S Dixie Dr Ste D201, St George, UT 84770 | 2018-01-31 |
| 1568981314 | Jeffrey Joseph Peterson | Behavior Technician | 162 N 400 E Ste A-105, St. George, UT 84770 | 2017-09-13 |
| 1992242549 | Zachary Carey | Specialist/Technologist | 1115 W Diamond Valley Dr, Saint George, UT 84770 | 2017-01-20 |
| 1669920427 | Charles Taylor Church | Technician, Other | 474 West 200 East, St. George, UT 84770 | 2016-09-21 |
| 1952755480 | Hollystic Hideaway | Voluntary or Charitable | 1418 W Sunset Blvd. # 2, Saint George, UT 84770 | 2016-04-21 |
| Find all providers in zip 84770 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093146912 | Tawni V Yardley | Nurse Practitioner | 1739 W Sunset Blvd, St George, UT 84770 | 2013-12-02 |
| 1851578777 | Deanne Staheli | Nurse Practitioner | 736 S 900 E, St George, UT 84790-7000 | 2008-01-22 |
| 1548234222 | Deborah D Barton | Nurse Practitioner | 1380 E Medical Center Dr, Ste # 4100, St George, UT 84790-2156 | 2006-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902405228 | Jodi Pitt Dawson | Nurse Practitioner | 4695 Porter Ave, Ogden, UT 84403-3834 | 2020-10-19 |
| 1043851116 | Kenzlee Wooden | Nurse Practitioner | 845 S Main St Ste A7, Bountiful, UT 84010-6482 | 2019-09-30 |
| 1265090922 | Nina Davis | Nurse Practitioner | 1247 E Mockingbird Ln, Sandy, UT 84094-3118 | 2019-05-29 |
| 1023412434 | Gaylinn Breeze | Nurse Practitioner | 7093 S 2980 W, West Jordan, UT 84084-2963 | 2014-10-14 |
| 1174936140 | Elizabeth Shade Cardenas | Nurse Practitioner | 500 Foothill Drive #182h, Veterans Healthcare Administration, Salt Lake City, UT 84148 | 2014-06-08 |
| 1124449285 | Jan Clements | Nurse Practitioner | 1605 E Shadow Cv, Cottonwood Heights, UT 84121-3664 | 2013-12-16 |
| 1366737579 | Matrix Medical Network of Utah,llc | Nurse Practitioner | 2150 S 1300 E Ste 500, Salt Lake City, UT 84106-4375 | 2011-06-15 |
| 1609104553 | Denise Westover | Nurse Practitioner | 5169 S. Cottonwood St, Ste. 520, Murray, UT 84107 | 2009-12-03 |
| 1134457682 | Edith A Shepherd | Nurse Practitioner | 6923 W Long Ridge Dr, Herriman, UT 84096-3466 | 2009-11-20 |
| 1265612097 | Solo Clinical Services LLC | Nurse Practitioner | 1864 Downington Ave, Salt Lake City, UT 84108-2912 | 2007-11-09 |
| 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.