CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION


Address: 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846
Phone: 8013592256

CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION (NPI# 1265892012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265892012
Entity Type Organization
Organization Name CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION
Other Organization Name SACRED CIRCLE HEALTH CARE
Practice Address 660 S 200 E Ste 250
Salt Lake City
UT 84111-3846
Mailing Address Hc 61 Box 6104
Ibapah
UT 84034-6003
Practice Telephone 8013592256
Practice Fax Number 8013644392
Mailing Telephone 8013592256
Mailing Fax Number 8013644392
Enumeration Date 2016-03-07
Last Update Date 2016-03-07
Authorized Official Name VIRGIL W JOHNSON (COUNCIL CHAIR)
Authorized Official Telephone 8018984814
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 291U00000X Clinical Medical Laboratory 9453799-8906 UT Laboratories

Other Provider/Organization Names

Other Name Type Code
Sacred Circle Health Care Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1396199972 Confederated Tribes of The Goshute Reservation Clinic/Center Hc 61 Box 6104, Ibapah, UT 84034-6003 2016-04-20
1750510277 Confederated Tribes of The Goshute Reservation General Practice 195 Tribal Center Rd, Ibapah, UT 84034 2009-07-06
1194189233 Confederated Tribes of The Goshute Reservation Clinic/Center 660 S 200 E, Suite 250, Salt Lake City, UT 84111-3835 2016-04-05
1003275280 Confederated Tribes of The Goshute Reservation Clinic/Center 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 2016-02-17
1467811562 Confederated Tribes of The Goshute Reservation Pharmacy 660 S 200 E, Salt Lake City, UT 84111-3835 2016-02-17
1174969125 Confederated Tribes of The Goshute Reservation Clinic/Center 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 2013-05-17
1992141964 Confederated Tribes of The Goshute Reservation Clinic/Center 660 S 200 E, Suite 250, Salt Lake City, UT 84111-3835 2013-05-17
1003251638 Confederated Tribes of The Goshute Reservation Pharmacy 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 2013-05-09

Office Location

Street Address 660 S 200 E STE 250
City SALT LAKE CITY
State UT
Zip Code 84111-3846

Providers in the same location

NPI Name Taxonomy Address Enumeration
1396844049 David J Hadley Dentist 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 2006-09-21
1669071395 Megan Sonja Sullivan Nurse Practitioner 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 2020-10-23
1386253532 Kelly Dorthea Hollie Social Worker 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 2020-07-23
1558903617 Natalie Linares Dental Hygienist 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 2019-10-10
1174175426 Michael Stephen Miles Physician Assistant 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 2019-07-16
1003474602 Elizabeth Neilson Physical Therapist 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 2019-05-30
1598238594 Elizabeth Annas Physical Therapist 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 2019-01-02
1265929640 Daniel Rodriguez Dentist 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 2018-04-20
1003275280 Confederated Tribes of The Goshute Reservation Clinic/Center 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 2016-02-17
1457722563 Matthew Lewis Dietitian, Registered 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 2015-10-15
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1316551336 Mary Ann Rush Case Manager/Care Coordinator 334 E. 100 S., Slc, UT 84111 2020-09-08
1790396554 Stephanie G Mishenko Military Health Care Provider 344e 100s, Slc, UT 84111 2020-08-13
1386264802 Mckensee M Carter Case Manager/Care Coordinator 334 E 100 S, Salt Lake City, UT 84111 2020-04-24
1316421761 Community Health Centers, Inc. Social Worker 610 S 200 E Ste #b, Salt Lake City, UT 84111 2018-09-21
1528545506 Lauren Brittney Harman Case Manager/Care Coordinator 344 E. 100 S., Salt Lake City, UT 84111 2018-07-23
1851896484 Shivani Chowdhary Dentist 370 E South Temple Ste 350, Salt Lake City, UT 84111 2018-03-26
1801390661 Jaylee Marie Watman Case Manager/Care Coordinator 344 E. 100 S. Ste 301, Salt Lake City, UT 84111 2018-03-19
1467963918 Victoira Julia Graham Case Management 344 East 100 South Ste 301, Salt Lake City, UT 84111 2017-10-23
1750805404 Kayla Hymas Behavioral Analyst 243 E. 400 S., Slc, UT 84111 2017-08-02
1134643224 Julie Peaslee Counselor 275 E South Temple Ste 110, Salt Lake City, UT 84111 2017-07-31
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Taxonomy Information

Taxonomy Code 291U00000X
Grouping Laboratories
Classification Clinical Medical Laboratory

Taxonomy Definition

(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063033249 Arches Research, Inc. Clinical Medical Laboratory 1960 S 4250 W, Salt Lake City, UT 84104-4836 2020-04-29
1750915658 Idbydna Inc. Clinical Medical Laboratory 675 S Arapeen Dr Ste 301, Salt Lake City, UT 84108-1223 2020-02-28
1700420361 Renalytix Ai, Inc. Clinical Medical Laboratory 421 S Wakara Way Ste 309, Salt Lake City, UT 84108-3549 2019-11-06
1154884575 Heredilab, Inc Clinical Medical Laboratory 1060 E 100 S Ste 109, Salt Lake City, UT 84102-4303 2019-04-11
1760965719 Valleylab Clinical Medical Laboratory 4460 S Highland Dr Ste 110, Salt Lake City, UT 84124-3550 2018-09-14
1205323300 Laboratory Corporation of America Clinical Medical Laboratory 1160 E 3900 S Ste 1200, Salt Lake City, UT 84124-1251 2018-04-16
1154855690 Navican Genomics Inc. Clinical Medical Laboratory 341 S Main St Ste 200, Salt Lake City, UT 84111-3463 2017-04-11
1679948756 Crossroads Laboratory, LLC Clinical Medical Laboratory 6337 S Highland Dr Ste 110, Salt Lake City, UT 84121-2107 2015-12-01
1508125196 Ethigen, LLC Clinical Medical Laboratory 1904 Michigan Ave, Salt Lake City, UT 84108-1324 2012-05-16
1699041723 Omega Wellness Institute, LLC Clinical Medical Laboratory 770 E South Temple Ste 100, Salt Lake City, UT 84102-1689 2012-03-22
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Competitor

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City SALT LAKE CITY
Zip Code 84111

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Dataset Information

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.

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