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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 291U00000X | Clinical Medical Laboratory | 9453799-8906 | UT | Laboratories |
Other Name | Type Code |
---|---|
Sacred Circle Health Care | Doing Business As Name - Organization |
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 |
Street Address |
660 S 200 E STE 250 |
City | SALT LAKE CITY |
State | UT |
Zip Code | 84111-3846 |
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 |
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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 |
Find all providers in zip 84111 |
Taxonomy Code | 291U00000X |
Grouping | Laboratories |
Classification | Clinical Medical Laboratory |
(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. |
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 |
Find all providers in SALT LAKE CITY |
City | SALT LAKE CITY |
Zip Code | 84111 |
Please comment or provide details below to improve the information on CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION.
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.