CREEKSIDE HOME HEALTH, LLC (NPI# 1366687865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366687865 |
| Entity Type | Organization |
| Organization Name | CREEKSIDE HOME HEALTH, LLC |
| Other Organization Name | CREEKSIDE HOME HEALTH |
| Practice Address |
3920 S 1100 E 250 Salt Lake City UT 84124-1213 |
| Practice Telephone | 8018102122 |
| Practice Fax Number | 3853475331 |
| Mailing Telephone | 8018102122 |
| Mailing Fax Number | 3853475331 |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2017-01-23 |
| Authorized Official Name | MR. DIEGO VALLI (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 80151854762 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 2017-HHA-UT00034 | UT | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | UT000349 | 05 |
| Other Name | Type Code |
|---|---|
| Creekside Home Health | Doing Business As Name - Organization |
| Street Address |
3920 S 1100 E 250 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84124-1213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538153234 | Leonard J Swinyer | Specialist | 3920 S 1100 E, Suite 310, Salt Lake City, UT 84124-1213 | 2005-09-08 |
| 1497164180 | Gitanjali Sharma | Nurse Practitioner | 3920 S 1100 E, Ste 250, Salt Lake City, UT 84124-1213 | 2014-08-06 |
| 1184980005 | Oral & Facial Reconstructive Surgeons of Utah, LLC | Dentist | 3920 S 1100 E, Suite 150, Salt Lake City, UT 84124-1213 | 2012-04-04 |
| 1598087603 | Karl E. Lind Dds, Inc | Dentist | 3920 S 1100 E, Ste 150, Salt Lake City, UT 84124-1213 | 2010-02-17 |
| 1306058052 | Scott R. Stein Dds, LLC | Dentist | 3920 S 1100 E, 370, Salt Lake City, UT 84124 | 2007-05-04 |
| 1982740361 | Elizabeth E Auger Dpm PC | Podiatrist | 3920 S 1100 E, #115, Salt Lake City, UT 84124-1213 | 2007-01-30 |
| 1639250673 | Michael A Gladwell | Oral & Maxillofacial Surgery | 3920 S 1100 E, Suite 150, Salt Lake City, UT 84124-1213 | 2006-10-18 |
| 1790724847 | Michael Richard Swinyer | Physician Assistant | 3920 S 1100 E, Suite 310, Salt Lake City, UT 84124-1213 | 2006-06-05 |
| 1689611824 | Max E. Jones | Podiatrist | 3920 S 1100 E, #115, Salt Lake City, UT 84124-1213 | 2006-05-31 |
| 1154380772 | Scott Raymond Stein | Dentist | 3920 S 1100 E, #370, Salt Lake City, UT 84124-1213 | 2006-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487273298 | Shannon Penny Price | Social Worker | 4465 Maybeck Place, Condo C, Millcreek, UT 84124 | 2020-04-11 |
| 1922654367 | Joseph C Melvin Md PC | Colon & Rectal Surgery | 1250 East 3900 South Ste 320, Salt Lake City, UT 84124 | 2019-08-12 |
| 1366923252 | Melanie Stumpf | Counselor | 1141 E 3900, Suite A170, Salt Lake City, UT 84124 | 2018-08-28 |
| 1376033993 | Michelle Flowers | Speech-Language Pathologist | 2120 East 3900 South, Ste 200, Holladay, UT 84124 | 2018-05-18 |
| 1740797257 | Lissa Anne Hutchings | Nurse Practitioner | 1160 E 3900 S Ste 4100, Salt Lake City, UT 84124 | 2018-01-05 |
| 1316465693 | Randy Gines | Counselor | 4460 S Highland Drive # 230, Murray, UT 84124 | 2017-09-06 |
| 1417470717 | Joshua Chandler Spencer | Counselor | 4460 South Highland Dr., 230, Murray, UT 84124 | 2017-07-19 |
| 1659891554 | Marcus Whitney | Counselor | 4460 S Highland Dr. # 230, Murray, UT 84124 | 2017-06-21 |
| 1518496884 | Courtney Nilson | Counselor | 4460 S. Highland Dr. #230, Murray, UT 84124 | 2017-06-08 |
| 1841687126 | Intrafilrx | Preferred Provider Organization | 3920 S 1100 E Ste 210, Salt Lake City, UT 84124 | 2015-04-23 |
| Find all providers in zip 84124 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518422 | Ascent Physical Therapy and Wellness | Home Health | 1549 W Haslam Cir, Salt Lake City, UT 84116-1633 | 2020-11-03 |
| 1356808653 | Nphalanx LLC | Home Health | 404 E 4500 S Ste B22, Salt Lake City, UT 84107-2776 | 2019-02-23 |
| 1750824553 | Emily R. Carlson | Home Health | 310 E Downington Ave, #3, Salt Lake City, UT 84115-2208 | 2016-11-28 |
| 1801286976 | Robert B Canaan | Home Health | 1900 S Douglas St Apt 2, Salt Lake City, UT 84105-3625 | 2015-01-28 |
| 1881083590 | Grandee Village Home Health Care Services LLC | Home Health | 3712 S Golden Grain Cir, Salt Lake City, UT 84120-3393 | 2015-01-19 |
| 1699197830 | Gsded, LLC | Home Health | 2020 S 1300 E, Suite C, Salt Lake City, UT 84105-3654 | 2014-01-07 |
| 1477980803 | Yswecan, LLC | Home Health | 5320 S 900 E Ste 280, Salt Lake City, UT 84117-7244 | 2013-09-30 |
| 1851686166 | Peak Specialty Group | Home Health | 1220 E 3900 S Ste 4d, Salt Lake City, UT 84124-1383 | 2011-06-14 |
| 1750675633 | Youthtrack, Inc. | Home Health | 261 E 4500 S, Salt Lake City, UT 84107-3865 | 2011-06-08 |
| 1114218781 | Valeo Home Healthcare Services | Home Health | 6076 South 900 East, Suite 150, Salt Lake City, UT 84121 | 2011-04-29 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84124 |
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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.