MOUNTAINSTAR MEDICAL GROUP TIMPANOGOS SPECIALTY CARE, LLC (NPI# 1184090870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184090870 |
| Entity Type | Organization |
| Organization Name | MOUNTAINSTAR MEDICAL GROUP TIMPANOGOS SPECIALTY CARE, LLC |
| Practice Address |
1020 S 1100 W Ste B Lehi UT 84043-6041 |
| Mailing Address |
2000 Health Park Dr Brentwood TN 37027-4525 |
| Practice Telephone | 8016532757 |
| Practice Fax Number | 8016532747 |
| Mailing Telephone | 6153737600 |
| Mailing Fax Number | 8663461426 |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | WILLIAM TEDRICK JOHNSON (GROUP VP/AO) |
| Authorized Official Telephone | 6153723375 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Street Address |
1020 S 1100 W STE B |
| City | LEHI |
| State | UT |
| Zip Code | 84043-6041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285264358 | Sojo Dental Lehi | Dentist | 3397 N. 1200 E., Ste #102, Lehi, UT 84043 | 2020-01-17 |
| 1932754165 | Mckenzie Ward | Speech-Language Pathologist | 2750 N Digital Dr Lehi, Lehi, UT 84043 | 2019-08-05 |
| 1780248336 | Kimberly Ann Henne | Nurse Practitioner | 3750 Digital Drive, Lehi, UT 84043 | 2019-04-30 |
| 1962961086 | Corporate Concierge | Optometrist | 4415 N Deer Ridge Trail, Lehi, UT 84043 | 2019-03-18 |
| 1518435692 | Brindie Allan Bishop | Midwife | 1202 W. 800 S., Lehi, UT 84043 | 2018-11-07 |
| 1841766821 | Dry Creek Pediatric Dentistry | Dentist | 3300 N Running Creek Way F101, Lehi, UT 84043 | 2018-10-17 |
| 1437634219 | Banyan Consulting | Assisted Living Facility | 301 N 1200 E, Lehi, UT 84043 | 2018-09-27 |
| 1174005508 | Cameron Ronald John | Psychologist | 3375 W. Mayflower Way, Suite A, Lehi, UT 84043 | 2018-09-01 |
| 1114415130 | Covington Senior Living of Lehi | Assisted Living Facility | 301 N. 1200 E., Lehi, UT 84043 | 2018-04-25 |
| 1669978060 | Mark Alleman | Physical Therapy Assistant | 2750 N Digital Dr., Lehi, UT 84043 | 2018-04-04 |
| Find all providers in zip 84043 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| 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 Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063851343 | Jenna Madsen | Obstetrics & Gynecology | 3401 N Center St Ste 150, Lehi, UT 84043-7501 | 2013-06-19 |
| 1609162296 | Emma J Miller | Obstetrics & Gynecology | 3401 N Center St, Suite 150, Lehi, UT 84043-7497 | 2011-06-22 |
| 1891050928 | Kristin Elizabeth Wexler | Obstetrics & Gynecology | 3401 N Center St, Suite 150, Lehi, UT 84043-7497 | 2012-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144753013 | Jessica Kaplan | Obstetrics & Gynecology | University of Utah University Hospital, 50 N Medical Drive, Salt Lake City, UT 84132-0001 | 2017-04-07 |
| 1326571621 | Kylie Measom Soffe | Obstetrics & Gynecology | Ob Gyn Administration 30 N 1900 E Rm 2b200, Salt Lake City, UT 84132-2101 | 2017-04-04 |
| 1326492109 | Pennington Medical Center | Obstetrics & Gynecology | 3507 N University Ave Ste 175, Provo, UT 84604-6692 | 2016-04-19 |
| 1629430046 | Chadwick Miles Densley | Obstetrics & Gynecology | 12842 South 3600 West, Suite 200, Riverton, UT 84065 | 2016-03-24 |
| 1639564016 | Kristen Hansord Lilja | Obstetrics & Gynecology | 82 S 1100 E Ste 305, Salt Lake City, UT 84102-4703 | 2015-04-01 |
| 1194119172 | Irina Cassimatis | Obstetrics & Gynecology | University of Utah Obgyn Dept, 30 N 1900 East. Room 2b200, Salt Lake City, UT 84132-0001 | 2015-03-26 |
| 1033509740 | Kathryn Fay | Obstetrics & Gynecology | 30 N 1900 E Rm 2a200, Salt Lake City, UT 84132-2209 | 2015-02-02 |
| 1932528676 | Aliye Runyan | Obstetrics & Gynecology | 30 North 1900 East 2a200, Dept of Obgyn, Salt Lake City, UT 84132 | 2014-04-09 |
| 1467870295 | Ashley Elizabeth Benson | Obstetrics & Gynecology | 30 N 9100 E, Room 2b200, Salt Lake City, UT 84132-0001 | 2014-03-29 |
| 1245656487 | Steve F Johnson | Obstetrics & Gynecology | 4647 Madison Ave, Ogden, UT 84403-3007 | 2014-03-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MOUNTAINSTAR MEDICAL GROUP TIMPANOGOS SPECIALTY CARE, LLC.
| 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.