STANSBURY PEDIATRICS, INC (NPI# 1366654535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366654535 |
| Entity Type | Organization |
| Organization Name | STANSBURY PEDIATRICS, INC |
| Practice Address |
210 Millpond Stansbury Park UT 84074 |
| Mailing Address |
Po Box 932 Sandy UT 84091-0932 |
| Practice Telephone | 4358821288 |
| Practice Fax Number | 4358821275 |
| Mailing Telephone | 8015539568 |
| Mailing Fax Number | 8015539562 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. HEIDI S MCMILLAN (OWNER) |
| Authorized Official Telephone | 4358821288 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080H0002X |
Pediatrics Specialization: Hospice and Palliative Medicine |
5904241-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 022588131001 | 05 |
| Street Address |
210 MILLPOND |
| City | STANSBURY PARK |
| State | UT |
| Zip Code | 84074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063729481 | Jennifer B Littledike | Physician Assistant | 210 Millpond, Stansbury Park, UT 84074-8187 | 2010-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689233397 | Leah Elizabeth Harper I | Behavior Technician | 39 Millpond Stansbury Park, Tooele, UT 84074 | 2019-06-07 |
| 1245710789 | Tanna Marie Shelley | Community Health Worker | 27 So Main St, Tooele, UT 84074 | 2018-08-15 |
| 1528548062 | Barbara T Cederlof | Community Health Worker | 27 South Main St., Tooele, UT 84074 | 2018-08-15 |
| 1235615600 | Ashley Christine Wilson | Case Manager/Care Coordinator | 27 South Main, Tooele, UT 84074 | 2018-07-18 |
| 1174016976 | Makenzie Green | Case Manager/Care Coordinator | 27 S Main, Tooele, UT 84074 | 2018-06-07 |
| 1386151835 | Monica Lee | Physical Therapist | 6727 Ut-36 #300, Stansbury Park, UT 84074 | 2018-01-05 |
| 1871976183 | Pagnani Physical Therapy | Physical Therapist | 6727 North State Hwy 36, Suite 300, Stansbury Park, UT 84074 | 2015-07-06 |
| 1407248222 | Pebble Creek Counseling Center | Counselor | 494 E 2400 N Ste B, Tooele, UT 84074 | 2015-03-03 |
| 1528496221 | Emily Carlson | Case Manager/Care Coordinator | 220 North Millpond Rd, Suite 100, Stansbury Park, UT 84074 | 2013-10-16 |
| 1710327218 | Angela Michelle Demoss | Nurse Practitioner | 682 Country Club, Stansbury Park, UT 84074 | 2013-06-28 |
| Find all providers in zip 84074 | ||||
| Taxonomy Code | 2080H0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Hospice and Palliative Medicine |
| A pediatrician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care. |
| Notes: Source: American Academy of Hospice and Palliative Medicine, www.aahpm.org [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881656106 | David Okubo | Pediatrics | 1995 W 9000 S, West Jordan, UT 84088-9345 | 2006-04-03 |
| 1851898365 | University of Utah Pediatric Acuity Care | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2018-04-11 |
| 1740499433 | Intermountain Pediatric Clinic | Pediatrics | 508 E South Temple, Suite 310, Salt Lake City, UT 84102-1013 | 2007-05-21 |
| 1952363285 | Jeffery B. Jackson | Pediatrics | 1995 W 9000 S, West Jordan, UT 84088-9345 | 2006-04-03 |
| City | STANSBURY PARK |
| Zip Code | 84074 |
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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.