MS. NICOLE I MEDINA (NPI# 1235488008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235488008 |
| Entity Type | Individual |
| Full Name | MS. NICOLE I MEDINA |
| Other Name | NICOLE SHEWEY |
| Credential | PSYD |
| Practice Address |
934 S Main St Layton UT 84041-7135 |
| Mailing Address |
Po Box 1348 West Jordan UT 84084-8348 |
| Practice Telephone | 8017737060 |
| Mailing Telephone | 8018504382 |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2020-08-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 10158726-2501 | UT | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
10158726-2501 | UT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | PROFESSIONAL LICENSE | 10158726-2501 | 01 |
| UT | 1235488008 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8184 S Highland Dr Ste C-104, Sandy, UT 840936477 | (385) 645-4357 | |
| 8160 S Highland Dr Ste C104, Sandy, UT 84093 | 8018504382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770612533 | Nicole Jennys Medina | Case Manager/Care Coordinator | 12450 Sw Fischer Rd Unit 225, Tigard, OR 97224-2378 | 2007-03-05 |
| 1093353617 | Nicole Medina | Pharmacist | 150 Calle F Vizcarrondo, San Juan, PR 00926-4483 | 2019-12-13 |
| 1962888404 | Nicole Medina | Physical Therapist | 5910 Pacific Ave, Stockton, CA 95207-4704 | 2015-08-06 |
| 1285023598 | Nicole Medina | Behavioral Analyst | 11755 Sw 90th St, 210, Miami, FL 33186-2177 | 2015-01-10 |
| Street Address |
934 S MAIN ST |
| City | LAYTON |
| State | UT |
| Zip Code | 84041-7135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417931296 | Julie A. Wiese | Psychiatry & Neurology | 934 S Main St, Layton, UT 84041-7135 | 2005-12-05 |
| 1831790492 | Danielle Lexus Ortega | Community Health Worker | 934 S Main St, Layton, UT 84041-7135 | 2020-11-02 |
| 1861092116 | Paula Lee Moffitt | Registered Nurse | 934 S Main St, Layton, UT 84041-7135 | 2020-10-27 |
| 1235737693 | Shelby Close | Community Health Worker | 934 S Main St, Layton, UT 84041-7135 | 2020-10-16 |
| 1659979334 | Mikey Francisco Jaramillo | Community Health Worker | 934 S Main St, Layton, UT 84041-7135 | 2020-10-14 |
| 1841897436 | Jadrian Seana Mcdonough | Community Health Worker | 934 S Main St, Layton, UT 84041-7135 | 2020-10-06 |
| 1679170542 | Mara Elizabeth Jeffs | Community Health Worker | 934 S Main St, Layton, UT 84041-7135 | 2020-10-05 |
| 1194322073 | Hayden Harold Arave | Community Health Worker | 934 S Main St, Layton, UT 84041-7135 | 2020-10-05 |
| 1487251666 | Jordon Ashley Robinson | Social Worker | 934 S Main St, Layton, UT 84041-7135 | 2020-10-01 |
| 1093322778 | Makayla Marie Lee Richards | Community Health Worker | 934 S Main St, Layton, UT 84041-7135 | 2020-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700499183 | Grab Healthcare, LLC | Clinic/Center | 245 E 2150 N, Suite C, Layton, UT 84041 | 2020-08-26 |
| 1154961399 | Victoria Leeann Taylor | Massage Therapist | 716 Antelope Dr, Layton, UT 84041 | 2020-01-15 |
| 1184181505 | Brian Taylor Woodbury | Occupational Therapist | 471 Heritage Park Blvd. Ste #5, Layton, UT 84041 | 2019-02-21 |
| 1740756816 | Jacob C Juarez | Physician Assistant | 2084 N. 1700 W., Suite A, Layton, UT 84041 | 2018-10-16 |
| 1134637945 | Jodi Lynn Siri | Counselor | 365 W 1550 N Ste F, Layton, UT 84041 | 2018-01-15 |
| 1083128029 | Utah Cvs Pharmacy LLC | Pharmacy | 50 South Fort Lane, Layton, UT 84041 | 2017-11-29 |
| 1376057315 | Utah Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2000 W & W 1700 S Nec, Layton, UT 84041 | 2017-11-29 |
| 1912411992 | Live Strong House LLC | Counselor | 377 N. Marshall Way, Suite 1b, Layton, UT 84041 | 2017-11-28 |
| 1003326505 | Kenneth L Ernstrom | Pharmacist | 2065 N Robins Drive, Layton, UT 84041 | 2017-10-10 |
| 1356868319 | Utah Home Health and Hospice LLC | Family Medicine | 920 W Heritage Park Blvd Suite 120, Layton, UT 84041 | 2017-08-29 |
| Find all providers in zip 84041 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629395181 | Kirt Cundick | Psychologist | 1454 N Hill Field Rd Ste 3, Layton, UT 84041-5061 | 2010-04-23 |
| 1619077161 | Kay Psychological and Consulting Services | Psychologist | 880 Heritage Park Blvd Ste 230c, Layton, UT 84041-5676 | 2006-09-24 |
| 1447210646 | Steven Kay | Psychologist | 1601 N Hill Field Rd, Suite 201, Layton, UT 84041-2161 | 2006-03-23 |
| 1194709980 | Thomas C Fairbank | Psychologist | 2084 N 1700 W Ste 6, Layton, UT 84041 | 2005-12-05 |
| 1043330178 | Scott W. Boyle | Psychologist | 934 S Main St, Layton, UT 84041-7135 | 2007-03-30 |
| 1336296003 | Mark David Corgiat | Psychologist | 1916 N 700 W, Suite 190, Layton, UT 84041-5673 | 2007-01-04 |
| 1437167392 | Virgil J Keate | Psychologist | 934 S Main St, Layton, UT 84041-7135 | 2006-08-04 |
| 1376558064 | Todd A Soutor | Psychologist | 934 S Main St, Layton, UT 84041-7135 | 2006-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205433059 | Steven Lucero | Psychologist | 93 S 1250 E, Logan, UT 84321-6770 | 2020-10-05 |
| 1023627759 | Wasatch Front Wellness, Pllc | Psychologist | 940 N 400 E Ste 3, North Salt Lake, UT 84054-1945 | 2020-07-29 |
| 1376165530 | Kirsten Leigh Graham | Psychologist | 351 W University Blvdgeneral Classrooms 308-o, General Classrooms 308-o, Cedar City, UT 84720 | 2020-05-11 |
| 1467073833 | Realign Psychology LLC | Psychologist | 1042 E Fort Union Blvd, #1085, Midvale, UT 84047-1800 | 2020-04-27 |
| 1508404344 | Rith Counseling and Assessment Pllc | Psychologist | 10432 S 4000 W, South Jordan, UT 84009-5729 | 2019-12-11 |
| 1780230433 | Carolynne Elizabeth Baron | Psychologist | Va Salt Lake City Healthcare System 500 Foothill Drive, Salt Lake City, UT 84148-0001 | 2019-08-16 |
| 1255999637 | Thomas Golightly | Psychologist | 1500 Wsc Byu, Provo, UT 84602 | 2019-05-31 |
| 1639732571 | Scott A Baldwin | Psychologist | 1190 N 900 E Ofc 285, Provo, UT 84604-3536 | 2019-04-16 |
| 1407311087 | Hiu Wai Caldwell | Psychologist | 796 E. Pacific Drive Suite B, American Fork, UT 84003-8400 | 2019-02-07 |
| 1992273734 | Tracy Ellis | Psychologist | 70 N Main St Ste 104, Bountiful, UT 84010-6115 | 2018-11-09 |
| 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.