SOUTHWEST SPINE AND PAIN CARE SPECIALISTS LLC (NPI# 1134582570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134582570 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST SPINE AND PAIN CARE SPECIALISTS LLC |
| Practice Address |
630 E 1400 N Suite 135 Logan UT 84341-2534 |
| Mailing Address |
652 S Medical Center Dr Suite 110 St George UT 84790-7049 |
| Practice Telephone | 4356562424 |
| Practice Fax Number | 5357878149 |
| Mailing Telephone | 4356562424 |
| Mailing Fax Number | 5357878149 |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2016-09-27 |
| Authorized Official Name | JON OBTAY (PRESIDENT) |
| Authorized Official Telephone | 4356562424 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508368465 | Southwest Spine and Pain Care Specialists LLC | Community/Behavioral Health | 1085 S Bluff St Ste 200, Saint George, UT 84770-5245 | 2018-03-06 |
| 1700234499 | Southwest Spine and Pain Care Specialists LLC | Anesthesiology | 1303 N Main St, Cedar City, UT 84721-9746 | 2016-06-02 |
| 1144509985 | Southwest Spine and Pain Care Specialists LLC | Internal Medicine | 652 S Medical Center Dr, Ste 110, Saint George, UT 84790-7017 | 2011-08-10 |
| Street Address |
630 E 1400 N SUITE 135 |
| City | LOGAN |
| State | UT |
| Zip Code | 84341-2534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902875669 | Northern Utah Endoscopy Center | Clinic/Center | 630 E 1400 N, Suite 100a, Logan, UT 84341-2534 | 2006-03-15 |
| 1215596192 | Stephanie Michelle Sampson | Nurse Practitioner | 630 E 1400 N, Logan, UT 84341-2691 | 2019-06-13 |
| 1972561165 | Bryan R. Larsen | Internal Medicine | 630 E 1400 N, Suite 100b, Logan, UT 84341-2534 | 2006-05-04 |
| 1336105360 | Verle Duane Bohman | Internal Medicine | 630 E 1400 N, Suite 100b, Logan, UT 84341-2534 | 2006-04-26 |
| 1629034855 | Northern Utah Gastroenterology and Endoscopy Specialists LLC | Internal Medicine | 630 E 1400 N, Logan, UT 84341-2534 | 2006-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701529 | Aubrey Salmond | Registered Nurse | 500 East 1500 N, Logan, UT 84341 | 2019-10-11 |
| 1043702046 | Eye Pros of Logan LLC | Optometrist | 1475 N Main St Ste 103, Logan, UT 84341 | 2018-06-05 |
| 1275050452 | Rylie Jeanne Cook | Student in an Organized Health Care Education/Training Program | 11 Aggie Village Apt. J, Logan, UT 84341 | 2017-08-28 |
| 1093262156 | Jessica Lynn Mcgarry | Social Worker | 1040 N 130 W, Apt 100, Logan, UT 84341 | 2016-09-07 |
| 1740663566 | Paul R Gregory | Occupational Therapy Assistant | 1300 N 500 E Suite 120, Suite 120, Logan, UT 84341 | 2015-06-30 |
| 1851708846 | Bradley Budge | Optometrist | 535 E 1400 N Ste 130, Logan, UT 84341 | 2014-07-22 |
| 1386058709 | Daniel Raymond Carlson | Physician Assistant | 500 E. 1400 N., Logan, UT 84341 | 2014-06-13 |
| 1902220239 | Work Injury Solutions Inc. | Clinic/Center | 630 E 1400 N Ste 140, Logan, UT 84341 | 2014-02-06 |
| 1750627287 | Lee Martin Williams Sr. | Counselor | 186 E. 1800 N., North Logan, UT 84341 | 2013-01-03 |
| 1669747804 | Ronald J Payne | Internal Medicine | 1726 North 1850 East, North Logan, UT 84341 | 2012-03-21 |
| Find all providers in zip 84341 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679916126 | Rodney Spencer Smith | Anesthesiology | 630 E 1400 N Ste 135, Logan, UT 84341-2549 | 2013-04-15 |
| 1043234685 | Interwest Comprehensive Pain Center | Anesthesiology | 2380 N 400 E, Ste A, Logan, UT 84341-1749 | 2006-07-27 |
| 1104852599 | Vikas Garg | Anesthesiology | 274 N Main St, Logan, UT 84321-3915 | 2006-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952865412 | Avail Medical LLC | Anesthesiology | 5742 S 1475 E Ste 200, South Ogden, UT 84403-4856 | 2019-01-29 |
| 1033597257 | Ashley Renee Donaldson | Anesthesiology | Spinal Interventions, 280 W River Park Drive Suite 200, Provo, UT 84604 | 2015-05-07 |
| 1609204338 | Interventional Spine & Pain Management | Anesthesiology | 5801 S Fashion Blvd Ste 180, Murray, UT 84107-8135 | 2013-10-15 |
| 1225387491 | Clinton D. Olsen | Anesthesiology | 280 W River Park Dr, Suite 200, Provo, UT 84604-5793 | 2012-09-04 |
| 1134429384 | Intermountain Medical Monitoring LLC | Anesthesiology | 1306 Deer Crest, Fruit Heights, UT 84037 | 2010-10-21 |
| 1861622219 | Jeremy Joyal | Anesthesiology | 11760 S 700 E Ste 112, Draper, UT 84020-6605 | 2009-07-20 |
| 1205058294 | Joseph Courtney Empey | Anesthesiology | 617 E Riverside Dr Ste 301, St George, UT 84790-8722 | 2007-05-02 |
| 1962439570 | Gordon Petty George, Md, PC | Anesthesiology | 800 N 700 W, Ste 340a, Orem, UT 84057 | 2006-06-27 |
| 1770558090 | Bryan C Hoelzer | Anesthesiology | 320 River Park Dr Ste 255, Provo, UT 84604 | 2006-02-21 |
| 1164421053 | Dale Gerald Stott | Anesthesiology | 301 N 200 E, Suite 2a, St George, UT 84770-3010 | 2005-07-21 |
| 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.