CENTRAL UTAH CLINIC, P.C. (NPI# 1134346976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134346976 |
| Entity Type | Organization |
| Organization Name | CENTRAL UTAH CLINIC, P.C. |
| Other Organization Name | REVERE HEALTH |
| Practice Address |
1184 E 80 N American Fork UT 84003-2906 |
| Mailing Address |
1055 N 500 W Attn: Credentialing Provo UT 84604-3305 |
| Practice Telephone | 8017633885 |
| Practice Fax Number | 8017633887 |
| Mailing Telephone | 8013548225 |
| Mailing Fax Number | 8014180941 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2018-03-07 |
| Authorized Official Name | JED BRADLEY HARSTON (DIRECTOR OF MANAGED CARE) |
| Authorized Official Telephone | 8018125012 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Revere Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669930475 | Central Utah Clinic, P.C. | Clinic/Center | 330 Falcon Ridge Pkwy Ste 400a, Mesquite, NV 89027-8881 | 2019-03-11 |
| 1851631139 | Central Utah Clinic, P.C. | Internal Medicine | 2019 E Riverside Dr, Suite A200, St George, UT 84790-8134 | 2013-02-22 |
| 1508896838 | Central Utah Clinic, P.C. | Family Medicine | 97 S Professional Way, Suite 2, Payson, UT 84651-1614 | 2006-07-03 |
| 1265907620 | Central Utah Clinic, P.C. | Eyewear Supplier (Equipment, not the service) | 5872 S 900 E Ste 100, Murray, UT 84121-1677 | 2018-10-11 |
| 1316330749 | Central Utah Clinic, P.C. | Non-Pharmacy Dispensing Site | 1055 N 500 W Ste 202, Provo, UT 84604-3305 | 2015-03-10 |
| 1689003550 | Central Utah Clinic, P.C. | Clinic/Center | 555 W Sr 164, Salem, UT 84653 | 2013-11-01 |
| 1780017954 | Central Utah Clinic, P.C. | Orthopaedic Surgery | 700 W 800 N Ste 100, Orem, UT 84057-6302 | 2013-08-12 |
| 1760752943 | Central Utah Clinic, P.C. | Orthopaedic Surgery | 1490 E Foremaster Dr, Suite 150, St George, UT 84790-4488 | 2012-01-05 |
| 1841433927 | Central Utah Clinic, P.C. | Urology | 15 S 1000 E, Suite 225, Payson, UT 84651-5590 | 2009-04-20 |
| 1023251204 | Central Utah Clinic, P.C. | Clinic/Center | 3000 N Triumph Blvd Ste 100, Lehi, UT 84043-4999 | 2009-04-17 |
| Street Address |
1184 E 80 N |
| City | AMERICAN FORK |
| State | UT |
| Zip Code | 84003-2906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447209473 | Kendra Ann Parker | Physician Assistant | 1184 E 80 N, American Fork, UT 84003-2906 | 2006-05-08 |
| 1457860934 | Christopher Jay Wilcox | Physician Assistant | 1184 E 80 N, American Fork, UT 84003-2906 | 2017-09-27 |
| 1477072015 | Brian Grier | Physician Assistant | 1184 E 80 N, American Fork, UT 84003-2906 | 2017-09-14 |
| 1093138976 | Andrew Benjamin Ward | Physician Assistant | 1184 E 80 N, American Fork, UT 84003-2906 | 2014-01-28 |
| 1518292655 | Brandon Carl Hanson | Physician Assistant | 1184 E 80 N, American Fork, UT 84003-2906 | 2009-10-07 |
| 1346478476 | Ryan Albert Slater | Family Medicine | 1184 E 80 N, American Fork, UT 84003-2906 | 2009-06-26 |
| 1134241904 | Russell Jack Gatenby | Physical Therapist | 1184 E 80 N, American Fork, UT 84003-2906 | 2007-04-04 |
| 1598887069 | John Robert Sumsion | Physical Therapist | 1184 E 80 N, American Fork, UT 84003-2906 | 2007-04-04 |
| 1891813960 | Central Utah Clinic, P.C. | Plastic Surgery | 1184 E 80 N, American Fork, UT 84003-2906 | 2007-03-27 |
| 1316064421 | Robert Todd Sumpter | Physician Assistant | 1184 E 80 N, American Fork, UT 84003-2906 | 2007-03-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851917496 | Centre Health Group | Clinic/Center | 70 West Main, Suite B, American Fork, UT 84003 | 2020-06-19 |
| 1457902553 | Lactation Link | Health Educator | 5524 Sicily Lane, Highland, UT 84003 | 2019-09-20 |
| 1750805511 | Eric Austin Haws | Physical Therapist | 1184 East 80 North, American Fork, UT 84003 | 2017-08-02 |
| 1578914784 | Ofa Moeai | Social Worker | 315 N 900 E, American Fork, UT 84003 | 2016-06-29 |
| 1639585839 | Carmel Ferreira | Acupuncturist | 42 N 200 E Ste 1, American Fork, UT 84003 | 2014-07-08 |
| 1619305869 | Luke Daren Sterger | Counselor | 995 West 1100 North, American Fork, UT 84003 | 2013-10-25 |
| 1356778252 | Reese & Weaver Dds LLC | Optometrist | 11038 N. Highland Blvd, Suite 200, Highland, UT 84003 | 2013-10-09 |
| 1518308444 | A Balanced Life Med Products | Durable Medical Equipment & Medical Supplies | 291 N 300 E Ste. C, American Fork, UT 84003 | 2013-07-08 |
| 1376981274 | Jesse Lucinda James | Family Medicine | 98 B. 1100 E. Suite #102, American Fork, UT 84003 | 2013-06-13 |
| 1922442904 | Premier Family Medical | Family Medicine | 226 N 100 E, Ste A, American Fork, UT 84003 | 2013-04-22 |
| Find all providers in zip 84003 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740371376 | John T Wells | Orthopaedic Surgery | 1184 E 80 N, American Fork, UT 84003-2906 | 2006-09-27 |
| 1275553612 | Alan M Banks | Orthopaedic Surgery | 1184 E 80 N, American Fork, UT 84003-2906 | 2006-07-20 |
| 1720021678 | Paul K Ritchie | Orthopaedic Surgery | 1184 E 80 N, American Fork, UT 84003-2906 | 2006-06-14 |
| 1932149895 | Gordon H Stock | Orthopaedic Surgery | 1184 E 80 N, American Fork, UT 84003-2906 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033757166 | Mountain West Spine and Orthopedics, LLC | Orthopaedic Surgery | 279 E 5900 S Ste 100, Murray, UT 84107-5422 | 2019-12-19 |
| 1639557168 | Hansen Orthopedics, P.C. | Orthopaedic Surgery | 1115 N 455 W Unit 8, Midway, UT 84049-6496 | 2015-05-17 |
| 1548651540 | Kevin Larkin | Orthopaedic Surgery | 3038 Polk Ave, Ogden, UT 84403-0589 | 2015-02-11 |
| 1083950794 | David Ross Mcnaught | Orthopaedic Surgery | 301 S 1200 E, Unit 42, Saint George, UT 84790-5538 | 2012-12-27 |
| 1033473574 | Enrique Feria-arias | Orthopaedic Surgery | 2356 N 400 E Ste 102, Tooele, UT 84074-3409 | 2012-06-29 |
| 1144582354 | Daniel Bradley Gibbs | Orthopaedic Surgery | 6360 S 3000 E # Sre210, Salt Lake City, UT 84121 | 2012-06-13 |
| 1437418217 | John Ryan Taylor | Orthopaedic Surgery | 700 W 800 N Ste 100, Orem, UT 84057-6301 | 2012-05-14 |
| 1821318494 | Mark D Hatch | Orthopaedic Surgery | 900 Round Valley Dr Ste 100, Park City, UT 84060-7552 | 2010-06-07 |
| 1003138785 | Mark Carl Thomas | Orthopaedic Surgery | 11611 Eureka Way, South Jordan, UT 84095-7916 | 2010-02-22 |
| 1326370537 | Marlan J Haslam | Orthopaedic Surgery | 1427 North Cisco Road, Laketown, UT 84038 | 2010-02-12 |
| Find all providers with the same taxonomy | ||||
| City | AMERICAN FORK |
| Zip Code | 84003 |
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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.