JAHAN IMANI MD PC (NPI# 1366560484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366560484 |
| Entity Type | Organization |
| Organization Name | JAHAN IMANI MD PC |
| Practice Address |
5315 Adams Ave Pkwy Suite A Washington Terrace UT 84405-4766 |
| Mailing Address |
P.o. Box 9519 Ogden UT 84409 |
| Practice Telephone | 8014755950 |
| Practice Fax Number | 8014757322 |
| Mailing Telephone | 8014757707 |
| Mailing Fax Number | 8014757322 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2019-05-13 |
| Authorized Official Name | DR. JAHAN IMANI (LEAD PHYSICIAN) |
| Authorized Official Telephone | 8014757707 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 57891911205 | UT | Other Service Providers |
| N | 174400000X | Specialist | 58040891205 | UT | Other Service Providers |
| N | 174400000X | Specialist | 51777271205 | UT | Other Service Providers |
| Y | 174400000X | Specialist | 2606151205 | UT | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | GOUP MEDICARE NUMBER | 000057660 | 01 |
| UT | 3010760 | 05 |
| Street Address |
5315 ADAMS AVE PKWY SUITE A |
| City | WASHINGTON TERRACE |
| State | UT |
| Zip Code | 84405-4766 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063414969 | Jahan Imani | Internal Medicine | 5315 Adams Ave Pkwy, Ste A, Washington Terrace, UT 84405-4766 | 2005-08-11 |
| 1679836951 | Jared D Abrams | Physician Assistant | 5315 Adams Ave Pkwy, Suite A, Washington Terrace, UT 84405-4766 | 2012-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669028171 | Alyssa House | Behavioral Analyst | 4933 1500 West #110, Riverdale, UT 84405 | 2019-08-12 |
| 1518525989 | Petersen Farms Assisted Living & Memory Care | Assisted Living Facility | 6980 S. 475 E., South Weber, UT 84405 | 2019-05-31 |
| 1376038141 | National Vision, Inc. | Technician/Technologist | 821 West Riverdale Road, Riverdale, UT 84405 | 2018-06-25 |
| 1194218461 | South Weber City | Ambulance | 7365 S 1375 E, South Weber, UT 84405 | 2018-06-12 |
| 1528572682 | Sandra Jo Scott | Dental Hygienist | 264 W Ridgeline Dr, Washington Terrace, UT 84405 | 2017-11-28 |
| 1376079061 | Loretta Shupe | Registered Nurse | 5319 S 500 E, Ogden, UT 84405 | 2017-05-02 |
| 1134661374 | Randy Ferrin | Registered Nurse | 5697 Maplewood Drive, South Ogden, UT 84405 | 2016-11-04 |
| 1871046284 | Karla Rosen | Counselor | 5202 S. Freeway Park Dr., Riverdale, UT 84405 | 2016-08-02 |
| 1053784520 | Jenifer Rebecca Nilson Smith | Physical Therapist | 5648 S. Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
| 1972976454 | Jenniferlyn Fletcher | Physical Therapy Assistant | 5648 South Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
| Find all providers in zip 84405 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194938191 | Wayne E Smith Md PC | Specialist | 5333 S Adams Ave Pkwy, Suite C, Washington Terrace, UT 84405 | 2007-05-07 |
| 1053495291 | Arterial and Cardiothoracic Surgery Consultants | Specialist | 425 E 5350 S 3500, Washington Terrace, UT 84405 | 2006-10-24 |
| 1770585564 | Jamal Horani | Specialist | 5315 Adams Ave, Suite A, Washington Terrace, UT 84405-1193 | 2005-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962045237 | Brian Baker | Specialist | 8796 S 4770 W, West Jordan, UT 84088-4930 | 2019-10-19 |
| 1477112464 | Protectus Wound Care | Specialist | 4 Ravenwood Ln, Sandy, UT 84092-4849 | 2019-06-12 |
| 1255803920 | Premier Pediatrics LLC | Specialist | 48 S 2500 W Ste 220, Hurricane, UT 84737-3380 | 2018-12-19 |
| 1255824090 | Jose Ramiro Izquierdo | Specialist | 6975 S Union Park Ctr, Cottonwood Heights, UT 84047-6048 | 2018-06-06 |
| 1669964516 | Marissa King | Specialist | 1141 E. 3900 S. Suite 150a, Salt Lake, UT 84121 | 2018-06-05 |
| 1306352091 | Gary Thomas | Specialist | 1820 Sidewinder Dr Ste 100, Park City, UT 84060-7563 | 2017-12-18 |
| 1922533751 | Natasha Peterson | Specialist | 84 E 150 N, American Fork, UT 84003-1624 | 2017-04-30 |
| 1265967814 | Sahra Askalany Affleck | Specialist | 5543 W 10180 N, Highland, UT 84003-9154 | 2017-04-20 |
| 1699209221 | Mountain Spine PC | Specialist | 11613 S State St, Draper, UT 84020-9456 | 2017-04-20 |
| 1215475116 | Megan Porter | Specialist | 307 N 300 W Ste 301, Kaysville, UT 84037-1852 | 2017-02-10 |
| Find all providers with the same taxonomy | ||||
| City | WASHINGTON TERRACE |
| Zip Code | 84405 |
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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.