UNIVERSITY OF UTAH ADULT SERVICES (NPI# 1144754938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144754938 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF UTAH ADULT SERVICES |
| Other Organization Name | MISSOULA BONE & JOINT SURGICAL CENTER |
| Practice Address |
2360 Mullan Rd Suite C Missoula MT 59808-1811 |
| Mailing Address |
Po Box 841450 Los Angeles CA 90084-1450 |
| Practice Telephone | 4065429695 |
| Mailing Telephone | 8012133900 |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2020-05-20 |
| Authorized Official Name | EDWARD CLARK (DEPARTMENT CHAIR) |
| Authorized Official Telephone | 8015876336 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | UNIVERSITY OF UTAH ADULT SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Missoula Bone & Joint Surgical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982135984 | University of Utah Adult Services | Audiologist | 417 S Wakara Way, 1112, Salt Lake City, UT 84108-1436 | 2017-03-22 |
| 1083158257 | University of Utah Adult Services | Dentist | 375 S Chipeta Way Ste A200, Salt Lake City, UT 84108-1261 | 2016-12-07 |
| 1649724139 | University of Utah Adult Services | Dermatology | 165 N. University Ave. Farmington, Farmington, UT 84025 | 2016-08-12 |
| 1255719407 | University of Utah Adult Services | Internal Medicine | 1208 Hilltop Dr Ste 102, Rock Springs, WY 82901-5858 | 2015-05-08 |
| 1932586294 | University of Utah Adult Services | Internal Medicine | 250 South Eagle Road, Meridian, ID 83642 | 2015-05-06 |
| 1629455282 | University of Utah Adult Services | Internal Medicine | 976 Mountian City Hwy, A Plus Total Care, Elko, NV 89801-2728 | 2015-05-04 |
| 1356745137 | University of Utah Adult Services | Internal Medicine | 1950 E Circle of Hope Drive, Salt Lake City, UT 84112 | 2014-10-22 |
| 1851904247 | University of Utah Adult Services | Orthopaedic Surgery | 9385 S Snowbird Center Dr, Sandy, UT 84092-6249 | 2020-08-26 |
| 1114431921 | University of Utah Adult Services | Internal Medicine | 1950 Circle of Hope Dr, Salt Lake City, UT 84112-5500 | 2017-12-01 |
| 1174033989 | University of Utah Adult Services | Clinic/Center | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2017-10-06 |
| Street Address |
2360 MULLAN RD SUITE C |
| City | MISSOULA |
| State | MT |
| Zip Code | 59808-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497747802 | Kay Lynn Kramer | Occupational Therapist | 2360 Mullan Rd, Ste D, Missoula, MT 59808-1811 | 2005-08-22 |
| 1891354684 | Tasha Nichole Kohlwes | Specialist/Technologist | 2360 Mullan Rd, Missoula, MT 59808-1811 | 2019-06-06 |
| 1306327317 | Sydney Williams | Physical Therapist | 2360 Mullan Rd, Missoula, MT 59808-1811 | 2018-08-27 |
| 1023542388 | University of Utah Pediatric Services | Pediatrics | 2360 Mullan Rd, Sutie C, Missoula, MT 59808-1811 | 2017-04-13 |
| 1689117194 | Matea Michelle Depoe | Specialist/Technologist | 2360 Mullan Rd, Suite D, Missoula, MT 59808-1811 | 2016-12-01 |
| 1972900157 | Vincent Keeney | Physician Assistant | 2360 Mullan Rd, Ste C, Missoula, MT 59808-1811 | 2014-12-03 |
| 1497158208 | Emily Beatrice Smith | Dietitian, Registered | 2360 Mullan Rd, Suite C, Missoula, MT 59808-1811 | 2014-10-07 |
| 1588079016 | Cynthia Deann Cleveland | Physical Therapist | 2360 Mullan Rd, Suite C, Missoula, MT 59808-1811 | 2014-06-23 |
| 1427312438 | Jesse Jeffrey Doll | Physician Assistant | 2360 Mullan Rd, Ste C, Missoula, MT 59808-1811 | 2012-06-25 |
| 1992016679 | Mike Kim Tran | Physical Therapist | 2360 Mullan Rd, Missoula, MT 59808-1811 | 2010-06-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447720875 | Megan Elizabeth Galliford | Behavioral Analyst | 1647 Shindig Dr, Apt 303, Missoula, MT 59808 | 2018-11-28 |
| 1518473560 | Willow Mahana Nelson Griffith | Registered Nurse | 2829 Great Northern Loop Ste 300, Missoula, MT 59808 | 2017-12-28 |
| 1043739428 | Carol Elizabeth Mckenzie | Student in an Organized Health Care Education/Training Program | 2705 Oshaughnessy St, Missoula, MT 59808 | 2017-09-16 |
| 1558884064 | Sharon Marie Herndon | Nurse Practitioner | 2230 N Reserve St Ste 402, Missoula, MT 59808 | 2017-07-18 |
| 1427594761 | Erin Boggs | Specialist/Technologist | 2921 Dublin St, Missoula, MT 59808 | 2017-01-10 |
| 1942603287 | Benjamin Cody Mcintosh | Chiropractor | 1070 N. Russell St., Missoula, MT 59808 | 2014-10-01 |
| 1518219617 | Pure Medical Inc | Ambulance | 5515 Bonanza Place, Missoula, MT 59808 | 2012-10-12 |
| 1932462231 | Kathleen F Calcagno | Specialist/Technologist | 2615 Connery Way, Suite 2b, Missoula, MT 59808 | 2012-06-21 |
| 1639454127 | Dentyn Dunaway | Pharmacist | 2527 N Reserve Street, Missoula, MT 59808 | 2011-10-15 |
| 1750557690 | Carl Thornblade, Md, Pllc | Allergy & Immunology | 2801 Great Northern Loop Ste 101, Missoula, MT 59808 | 2008-04-30 |
| Find all providers in zip 59808 | ||||
| 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 |
|---|---|---|---|---|
| 1578572129 | Justin A. Jacobson | Orthopaedic Surgery | 2831 Fort Missoula Road, Suite 232, Missoula, MT 59804 | 2006-08-05 |
| 1548255540 | Jeffrey Mariano Laporte | Orthopaedic Surgery | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2005-09-15 |
| 1174523336 | Larry R. Stayner | Orthopaedic Surgery | 2740 South Ave W Ste 101, Missoula, MT 59804-5137 | 2005-07-28 |
| 1144669912 | James Joseph Gholson | Orthopaedic Surgery | 2360 Mullan Rd Ste C, Missoula, MT 59808 | 2013-06-14 |
| 1174968416 | Zackery W Witte | Orthopaedic Surgery | 2360 Mullan Rd Ste C, Missoula, MT 59808 | 2013-04-30 |
| 1356637995 | Daniel R Whiting | Orthopaedic Surgery | 2740 South Ave W Ste 101, Missoula, MT 59804-5137 | 2011-06-22 |
| 1770882565 | Jessica Jewel Maxine Telleria | Orthopaedic Surgery | 2740 South Ave W Ste 101, Missoula, MT 59804-5137 | 2011-03-20 |
| 1659692929 | Daniel Dixon | Orthopaedic Surgery | 2740 South Ave W Ste 101, Missoula, MT 59804-5137 | 2010-06-21 |
| 1063654283 | Taylor Buckley | Orthopaedic Surgery | 2740 South Ave W Ste 101, Missoula, MT 59804-5137 | 2009-04-02 |
| 1346374972 | James R Burton | Orthopaedic Surgery | 2825 Fort Missoula Rd, Suite 317a, Missoula, MT 59804-7420 | 2007-03-15 |
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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.