CONNECTED MEDICAL GROUP, L L C (NPI# 1245709807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245709807 |
| Entity Type | Organization |
| Organization Name | CONNECTED MEDICAL GROUP, L L C |
| Practice Address |
2306 E 3860 S St George UT 84790-5025 |
| Mailing Address |
Po Box 239 Rupert ID 83350-0239 |
| Practice Telephone | 2089368206 |
| Mailing Telephone | 1888221042 |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2020-03-03 |
| Authorized Official Name | DEE ANNA KNIGHT (BILLING DIRECTOR) |
| Authorized Official Telephone | 2089368206 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2306 E 3860 S |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84790-5025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342713 | Katrina Poulsen | Student in an Organized Health Care Education/Training Program | 617 East Rriverside Dr, Ste 301, St. George, UT 84790 | 2020-10-08 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1366066417 | Benjamin Todd Lloyd | Dentist | 1683 E. Wolf Hole Dr, St. George, UT 84790 | 2020-06-04 |
| 1801434584 | Jennifer M Putnam | Marriage & Family Therapist | 321 North Mall Drive, Vw103, St. George, UT 84790 | 2019-12-12 |
| 1326683012 | Red Mountain Counseling and Education | Counselor | 321 No Mall Dr, Vw 103, St. George, UT 84790 | 2019-11-17 |
| 1295376002 | Karynne Kimberly Simpson | Behavior Technician | 280 N 1680 E U1, St. George, UT 84790 | 2019-10-02 |
| 1962053017 | Mikala Larsen | Nurse Practitioner | 1380 S Medical Center Dr., Saint George, UT 84790 | 2019-09-20 |
| 1326690678 | Joe Ballent | Student in an Organized Health Care Education/Training Program | 1526 S Medical Center Dr Ste 224a, St George, UT 84790 | 2019-07-16 |
| 1558923854 | David Pace | Optometrist | 749 South River Rd, St. George, UT 84790 | 2019-07-08 |
| 1639734924 | Mariah Ann Mertlich | Behavioral Analyst | 280 N 1680 E, U1, St. George, UT 84790 | 2019-05-02 |
| Find all providers in zip 84790 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265063531 | Rachelle Sullivan | Nurse Practitioner | 3301 E 3100 S, St George, UT 84790-1385 | 2020-01-27 |
| 1407321722 | Trent Kenworthy | Nurse Practitioner | 617 E Riverside Dr Apt 302, St George, UT 84790-8722 | 2018-10-13 |
| 1154800761 | Rebekah Leigh Bracken | Nurse Practitioner | 2351 S River Rd Ste 5, St George, UT 84790-8280 | 2018-08-14 |
| 1124571187 | Jennette Watts | Nurse Practitioner | 348 N Bluff St # 202, St George, UT 84770-4832 | 2016-07-26 |
| 1750789954 | Staci Steed | Nurse Practitioner | 1037 E 100 S, St George, UT 84770-3006 | 2014-12-21 |
| 1962808840 | Donna De Silva | Nurse Practitioner | 1240 E 100 S Ste 18b, St George, UT 84790-3074 | 2014-11-05 |
| 1205242773 | Brady Golding | Nurse Practitioner | 1134 E Fort Pierce Dr N, St George, UT 84790-8897 | 2014-07-06 |
| 1669814489 | Dawn Hansen | Nurse Practitioner | 295 S 1470 E # 300, St George, UT 84790-1762 | 2013-07-22 |
| 1972846384 | Alberto W Souza | Nurse Practitioner | 169 W 2710 South Cir Ste 201b, St George, UT 84790-7204 | 2013-04-03 |
| 1083925408 | Jennifer H Fisher | Nurse Practitioner | 652 S Medical Center Dr Ste 310, St George, UT 84790-7266 | 2010-06-30 |
| Find all providers in ST GEORGE | ||||
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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.