DR. FREDERIC M CIVISH III (NPI# 1124137278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124137278 |
| Entity Type | Individual |
| Full Name | DR. FREDERIC M CIVISH III |
| Practice Address |
3534 S 6000 W West Valley UT 84128-2610 |
| Mailing Address |
3354 W 7800 S West Jordan UT 84088-4506 |
| Practice Telephone | 8019696264 |
| Practice Fax Number | 8019696333 |
| Mailing Telephone | 8012822677 |
| Mailing Fax Number | 8012824654 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2017-01-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 184916-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
3534 S 6000 W |
| City | WEST VALLEY |
| State | UT |
| Zip Code | 84128-2610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437357241 | Janine Marie Mcdonald | Nurse Practitioner | 3534 S 6000 W, West Valley, UT 84128-2610 | 2007-07-03 |
| 1194860569 | Hunter Medical Center, Inc | Family Medicine | 3534 S 6000 W, West Valley, UT 84128-2610 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437572526 | Aimee E Wetzel | Social Worker | 5698 S Glen Eagle Dr, West Valley, UT 84128 | 2014-01-27 |
| 1285903641 | Tu Phan | Pharmacist | 5630 W 4100 South, West Valley City, UT 84128 | 2011-12-14 |
| 1548342553 | Lds Family Services | Counselor | 5698 West Glen Eagle Drive, West Valley City, UT 84128 | 2006-10-19 |
| 1003465725 | Alisa L Harmon | Counselor | Lds Family Services, 5698 Glen Eagle Drive, West Valley City, UT 84128 | 2019-09-05 |
| 1871053199 | Amir Varedi | Student in an Organized Health Care Education/Training Program | 3100 N. Tenaya Way, Graduate Medical Education, Las Vegas, NV 84128-0431 | 2019-03-22 |
| 1417135617 | Tina M Chandler | Dietitian, Registered | 3022 Kapford Dr, West Valley City, UT 84128-1374 | 2008-02-11 |
| 1629415559 | Siuea Pete Kupu | Pharmacist | 3571 S Highlander St, Salt Lake City, UT 84128-2317 | 2013-06-01 |
| 1467731182 | Celia Moleni Ale | Social Worker | 6471 W Newton Farm Dr, West Valley, UT 84128-2408 | 2011-08-11 |
| 1053942466 | Brenda M Woodhouse | Nutritionist | 6104 W Ginny Cir, West Valley, UT 84128-2530 | 2020-02-04 |
| 1245290691 | Rick Hackford | Specialist/Technologist | 6270 W 3705 S, West Valley City, UT 84128-2560 | 2006-03-27 |
| Find all providers in zip 84128 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053348599 | Timothy Vincent Siepel | Family Medicine | 8912 Hebdon Rd, West Valley, NY 14171-9741 | 2006-06-28 |
| 1194860569 | Hunter Medical Center, Inc | Family Medicine | 3534 S 6000 W, West Valley, UT 84128-2610 | 2007-02-21 |
| 1073613014 | Tim Siepel Md P.C. | Family Medicine | 8912 Hebdon Rd, West Valley, NY 14171-9741 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453160 | Utah Valley Natural Health Clinic | Family Medicine | 3311 N University Ave Ste 100, Provo, UT 84604-7432 | 2020-10-06 |
| 1528665411 | Rejuvaroom LLC | Family Medicine | 954 N 200 E, Spanish Fork, UT 84660-1247 | 2020-10-05 |
| 1356957468 | Aubrie Dawn Tilley | Family Medicine | 1741 E Imperial Park Ln, Salt Lake City, UT 84106-3379 | 2020-09-23 |
| 1588274013 | Jack L Cox | Family Medicine | 1588 N Dutch Meadows Ln, Midway, UT 84049-1275 | 2020-08-10 |
| 1457969834 | Sandra Lee Porter | Family Medicine | 3979 S Jester Dr, Salt Lake City, UT 84123-1227 | 2020-07-21 |
| 1265057673 | Onsite Care Clinics | Family Medicine | 230 S 500 E Ste 510, Salt Lake City, UT 84102-2028 | 2020-06-11 |
| 1154942985 | Healing Center of Utah | Family Medicine | 2630 W 3500 S Ste B, West Valley City, UT 84119-3113 | 2020-05-04 |
| 1649805813 | Hilorie Edwards Garside | Family Medicine | 3024 W 300 N Ste 3, West Point, UT 84015-7258 | 2020-03-09 |
| 1417595497 | Regenerative Medicine of Utah, LLC | Family Medicine | 2297 N Hill Field Rd Ste 101, Layton, UT 84041-6927 | 2019-12-20 |
| 1871131623 | In Home Provider | Family Medicine | 2432 Concord Ave, Santa Clara, UT 84765-5621 | 2019-12-11 |
| Find all providers with the same taxonomy | ||||
| City | WEST VALLEY |
| Zip Code | 84128 |
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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.