SALT LAKE CITY VAMC (NPI# 1356812655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356812655 |
| Entity Type | Organization |
| Organization Name | SALT LAKE CITY VAMC |
| Practice Address |
5957 Fashion Point Dr South Ogden UT 84403-5180 |
| Mailing Address |
Po Box 94463 Cleveland OH 44101-4463 |
| Practice Telephone | 9135784409 |
| Mailing Telephone | 9135784409 |
| Enumeration Date | 2018-12-12 |
| Last Update Date | 2018-12-12 |
| Authorized Official Name | ERIN DENISE POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QV0200X |
Clinic/Center Specialization: VA |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| SOUTH OGDEN 1 VA CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659980316 | Salt Lake City Vamc | Clinic/Center | 2380 N 400 E Ste G, North Logan, UT 84341-1769 | 2020-07-29 |
| 1124419551 | Salt Lake City Vamc | Clinic/Center | 189 S 600 W, Suite B, Price, UT 84501-2833 | 2015-02-06 |
| 1295126621 | Salt Lake City Vamc | Clinic/Center | 2719 Argent Avenue, Suite 9, Elko, NV 89801-8443 | 2015-02-06 |
| 1124062898 | Salt Lake City Vamc | Clinic/Center | 245 W 200 N, Roosevelt, UT 84066-2740 | 2006-06-15 |
| 1184664559 | Salt Lake City Vamc | Clinic/Center | 230 N 1680 E, Building N, St George, UT 84790-2579 | 2006-06-07 |
| 1093753675 | Salt Lake City Vamc | Clinic/Center | 774 S State St, Orem, UT 84058-6308 | 2006-06-03 |
| 1497146823 | Salt Lake City Vamc | Clinic/Center | 640 S Woodruff Ave, Idaho Falls, ID 83401-5299 | 2015-02-06 |
| 1619113115 | Salt Lake City Vamc | Clinic/Center | 2750 S 5600 W, West Valley City, UT 84120-1249 | 2009-01-05 |
| 1407894868 | Salt Lake City Vamc | Clinic/Center | 982 Chambers St, South Ogden, UT 84403-4571 | 2006-06-04 |
| 1487691002 | Salt Lake City Vamc | Clinic/Center | 500 S 11th Ave, Pocatello, ID 83201-4835 | 2006-06-01 |
| Street Address |
5957 FASHION POINT DR |
| City | SOUTH OGDEN |
| State | UT |
| Zip Code | 84403-5180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497198311 | Kevin Layne Blanchard | Physical Therapist | 5957 Fashion Point Dr, Ste. 102, South Ogden, UT 84403-5180 | 2013-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744632 | Megan Louise Larkins | Specialist/Technologist | 4000 Brinker Ave. The Apartments., Apartment 15, Ogden, UT 84403 | 2020-09-11 |
| 1154959062 | Joshua Clifford Hansen | Student in an Organized Health Care Education/Training Program | 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 | 2020-03-28 |
| 1346895935 | Positional Release Therapy Institute LLC | Specialist/Technologist | 1702 E. 5600 S., Ogden, UT 84403 | 2019-08-09 |
| 1841842077 | Braken Wooden | Chiropractor | 1893 Skyline Dr., Suite 204, South Ogden, UT 84403 | 2019-07-09 |
| 1023670569 | Wasatch Advanced Dental Care LLC | Dentist | 3590 Harrison Blvd Suite #1, Ogden, UT 84403 | 2019-07-05 |
| 1194237636 | Marci Niemeyer | Physician Assistant | 5929 Fashion Point Dr Ste 101, South Ogden, UT 84403 | 2017-10-24 |
| 1578081949 | Stephanie Jensen | Specialist/Technologist | 1473 36th Street, Ogden, UT 84403 | 2017-09-06 |
| 1891213385 | Forrest Sutherland | Specialist/Technologist | 1075 E 41st St., Ogden, UT 84403 | 2017-09-05 |
| 1184159022 | Nicole Lee Van Tassell | In Home Supportive Care | 1496 East 5600 South, Unit 6, Ogden, UT 84403 | 2017-04-28 |
| 1265889166 | Modern Dental Professionals Ut, PC | Dentist | 5974 S. Fashion Pointe Drive, Suite 210, South Ogden, UT 84403 | 2016-05-20 |
| Find all providers in zip 84403 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407894868 | Salt Lake City Vamc | Clinic/Center | 982 Chambers St, South Ogden, UT 84403-4571 | 2006-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659980316 | Salt Lake City Vamc | Clinic/Center | 2380 N 400 E Ste G, North Logan, UT 84341-1769 | 2020-07-29 |
| 1124419551 | Salt Lake City Vamc | Clinic/Center | 189 S 600 W, Suite B, Price, UT 84501-2833 | 2015-02-06 |
| 1124062898 | Salt Lake City Vamc | Clinic/Center | 245 W 200 N, Roosevelt, UT 84066-2740 | 2006-06-15 |
| 1184664559 | Salt Lake City Vamc | Clinic/Center | 230 N 1680 E, Building N, St George, UT 84790-2579 | 2006-06-07 |
| 1093753675 | Salt Lake City Vamc | Clinic/Center | 774 S State St, Orem, UT 84058-6308 | 2006-06-03 |
| 1538550959 | Grand Junction Vamc | Clinic/Center | 702 S Main St, Suite 5b, Moab, UT 84532-2943 | 2015-02-06 |
| 1619113115 | Salt Lake City Vamc | Clinic/Center | 2750 S 5600 W, West Valley City, UT 84120-1249 | 2009-01-05 |
| City | SOUTH OGDEN |
| Zip Code | 84403 |
Please comment or provide details below to improve the information on SALT LAKE CITY VAMC.
| 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.