OLYMPUS VALLEY SURGICAL ASSOICATES PLLC (NPI# 1164965570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164965570 |
| Entity Type | Organization |
| Organization Name | OLYMPUS VALLEY SURGICAL ASSOICATES PLLC |
| Practice Address |
1220 E 3900 S Ste 4e Salt Lake City UT 84124-1343 |
| Mailing Address |
13737 Noel Rd 1600 Dallas TX 75240-1331 |
| Practice Telephone | 9732511132 |
| Mailing Telephone | 9548382371 |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2020-06-12 |
| Authorized Official Name | KATHLEEN KONDAS (OFFICER) |
| Authorized Official Telephone | 9732511132 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0127X |
Surgery Specialization: Trauma Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
1220 E 3900 S STE 4E |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84124-1343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730249582 | James C Pingree | Neurological Surgery | 1220 E 3900 S Ste 4e, Salt Lake City, UT 84124-1343 | 2006-12-11 |
| 1700093879 | Neurosurgery & Spine Inc | Specialist | 1220 E 3900 S Ste 4e, Salt Lake City, UT 84124-1343 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487273298 | Shannon Penny Price | Social Worker | 4465 Maybeck Place, Condo C, Millcreek, UT 84124 | 2020-04-11 |
| 1922654367 | Joseph C Melvin Md PC | Colon & Rectal Surgery | 1250 East 3900 South Ste 320, Salt Lake City, UT 84124 | 2019-08-12 |
| 1366923252 | Melanie Stumpf | Counselor | 1141 E 3900, Suite A170, Salt Lake City, UT 84124 | 2018-08-28 |
| 1376033993 | Michelle Flowers | Speech-Language Pathologist | 2120 East 3900 South, Ste 200, Holladay, UT 84124 | 2018-05-18 |
| 1740797257 | Lissa Anne Hutchings | Nurse Practitioner | 1160 E 3900 S Ste 4100, Salt Lake City, UT 84124 | 2018-01-05 |
| 1316465693 | Randy Gines | Counselor | 4460 S Highland Drive # 230, Murray, UT 84124 | 2017-09-06 |
| 1417470717 | Joshua Chandler Spencer | Counselor | 4460 South Highland Dr., 230, Murray, UT 84124 | 2017-07-19 |
| 1659891554 | Marcus Whitney | Counselor | 4460 S Highland Dr. # 230, Murray, UT 84124 | 2017-06-21 |
| 1518496884 | Courtney Nilson | Counselor | 4460 S. Highland Dr. #230, Murray, UT 84124 | 2017-06-08 |
| 1841687126 | Intrafilrx | Preferred Provider Organization | 3920 S 1100 E Ste 210, Salt Lake City, UT 84124 | 2015-04-23 |
| Find all providers in zip 84124 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699327684 | Walter S Medlin Md PC | Surgery | 1046 E 100 S Ste A, Salt Lake City, UT 84102-1520 | 2019-07-10 |
| 1912439530 | Meghan Eileen Mali | Surgery | University of Utah Hospital General Surgery, 30 N. 1900 E., Salt Lake City, UT 84132-0001 | 2017-04-02 |
| 1124438924 | James Glen O'loughlin | Surgery | 30 N 1900 E Rm 3b324, Salt Lake City, UT 84132-0001 | 2014-05-01 |
| 1639457542 | August Robert Bauer Jr. | Surgery | 3115 East Lion Lane, Suite 160, Salt Lake City, UT 84121 | 2011-07-26 |
| 1154611986 | Anthony Wayne Bacon | Surgery | 30 N 1900 E Rm 3c344, Salt Lake City, UT 84132-0002 | 2011-04-13 |
| 1902109549 | Bariatric Medicine Institute | Surgery | 1046 E. 100 S., Salt Lake City, UT 84102 | 2010-12-20 |
| 1235468471 | J Barry Robb Md Professional Corporation | Surgery | 1220 E 3900 S Ste 3f, Salt Lake City, UT 84124-1326 | 2009-12-17 |
| 1609020130 | Alexander Wojciech Pastuszak | Surgery | 30 N 1900 E Dept Of, Salt Lake City, UT 84132-0002 | 2008-11-11 |
| 1326209735 | Scott Short | Surgery | 100 N Mario Capecchi Dr Ste 3800, Salt Lake City, UT 84113-1103 | 2008-06-18 |
| 1003076779 | Gregory Lawrence Livers | Surgery | 129 F St, Salt Lake City, UT 84103-2601 | 2008-06-16 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84124 |
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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.