MMG LLC (NPI# 1295392645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295392645 |
| Entity Type | Organization |
| Organization Name | MMG LLC |
| Other Organization Name | MOBILE MEDICAL GROUP |
| Practice Address |
450 S 900 E Ste 175 Salt Lake City UT 84102-2981 |
| Practice Telephone | 8014562333 |
| Practice Fax Number | 8014562330 |
| Mailing Telephone | 8014562333 |
| Mailing Fax Number | 8014562330 |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2020-07-15 |
| Authorized Official Name | KENNETH E NORRIS (MANAGING PARTNER) |
| Authorized Official Telephone | 8014856166 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Mobile Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407469166 | Mmg LLC | Nurse Practitioner | 80 Cottonwood Ct Ste 150, Eagle, ID 83616-6577 | 2020-08-24 |
| 1699383794 | Mmg LLC | Nurse Practitioner | 2000 S Colorado Blvd Ste 110, Denver, CO 80222-7917 | 2020-07-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | MMG LLC | 4277 North Pin Oak Drive, Randleman, NC 27317 |
| Street Address |
450 S 900 E STE 175 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84102-2981 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821561408 | Terra Bowden | Family Medicine | 450 S 900 E Ste 175, Salt Lake City, UT 84102-2981 | 2019-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1093359960 | Hayle Mayer | Behavior Technician | 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 | 2019-11-04 |
| 1326680869 | Ronald Mcdonald House of The Intermountain Area | Meals | 935 E. South Temple, Salt Lake City, UT 84102 | 2019-10-16 |
| 1508419581 | Claire Pemberton | Behavior Technician | 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 | 2019-07-19 |
| 1558923144 | Olivia Anne Hardwick | Social Worker | Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 | 2019-07-03 |
| 1649741802 | Colten Vancampen | Behavior Technician | 515 S 700 E #2a, Salt Lake City, UT 84102 | 2018-12-16 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1104311661 | Malorey Kooyman | Behavior Technician | 515 700 East, Suite 2a, Salt Lake City, UT 84102 | 2018-06-27 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| Find all providers in zip 84102 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (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. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467085019 | Hillary Price | Nurse Practitioner | 30 N Medical Drive, Salt Lake City, UT 84132-0001 | 2020-02-21 |
| 1467093328 | Tessa Rachel Curtis | Nurse Practitioner | 1160 E 3900 S Ste 3100, Salt Lake City, UT 84124-1202 | 2019-10-02 |
| 1033773544 | Marathon Health, LLC | Nurse Practitioner | 1930 S State St, Salt Lake City, UT 84115-2311 | 2019-04-30 |
| 1912488347 | Wendy Jane Frey | Nurse Practitioner | 3490 E Hermes Dr, Salt Lake City, UT 84124-3211 | 2018-08-23 |
| 1851813299 | Wayne Berg | Nurse Practitioner | 1060 E 100 S Ste 110, Salt Lake City, UT 84102-1591 | 2017-07-07 |
| 1982051785 | Patricia M Starks | Nurse Practitioner | 2678 S Glenmare St, Salt Lake City, UT 84106-3606 | 2016-05-21 |
| 1215392287 | Chad Dorman Dansie | Nurse Practitioner | 200 N Mario Capecchi Dr, Salt Lake City, UT 84132-0001 | 2015-12-17 |
| 1346642121 | Randi Moore Hollis | Nurse Practitioner | 1220 E 3900 S Ste 1f, Salt Lake City, UT 84124-1327 | 2014-09-23 |
| 1699049866 | Keri Page | Nurse Practitioner | 100 Mario Capecchi Dr Ste 2600, Salt Lake City, UT 84113-1103 | 2012-03-05 |
| 1710267877 | Trudy L. Hardin-reynolds | Nurse Practitioner | 825 Northcrest Dr, Salt Lake City, UT 84103-3320 | 2011-08-22 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84102 |
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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.