SOUTHERN UTAH NEUROLOGY, INC. (NPI# 1407239080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407239080 |
| Entity Type | Organization |
| Organization Name | SOUTHERN UTAH NEUROLOGY, INC. |
| Practice Address |
640 E 700 S #204 St George UT 84770-5732 |
| Practice Telephone | 4359864300 |
| Practice Fax Number | 4359864310 |
| Mailing Telephone | 4359864300 |
| Mailing Fax Number | 4359864310 |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |
| Authorized Official Name | REBECCA A JOHNSON (OFFICE MANAGER) |
| Authorized Official Telephone | 4356684618 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Street Address |
640 E 700 S #204 |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84770-5732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215908322 | Jacqueline L Murray | Physician Assistant | 640 E 700 S, #105, St George, UT 84770-4023 | 2006-01-27 |
| 1023480449 | Heather Rose Bandle | Nurse Practitioner | 640 E 700 S, Suite 105, St George, UT 84770-4023 | 2015-10-25 |
| 1275916777 | Andrus Prosthodontics Lc | Prosthetic/Orthotic Supplier | 640 E 700 S, Suite 104, St George, UT 84770-4023 | 2015-07-01 |
| 1851788590 | Heath Gabriel Dehart | Physician Assistant | 640 E 700 S, Suite 105, St George, UT 84770-4023 | 2015-04-21 |
| 1568701456 | Life Balance Clinic | Chiropractor | 640 E 700 S, Ste 203, St George, UT 84770-4023 | 2013-02-12 |
| 1861766586 | Justin Gordon | Marriage & Family Therapist | 640 E 700 S, Suite 201, St George, UT 84770-4023 | 2012-02-27 |
| 1164690467 | Robin Berger Md PC | Dermatology | 640 E 700 S, Suite 1, St George, UT 84770-4023 | 2008-02-20 |
| 1356551444 | Richard J. Kunde | Dentist | 640 E 700 S, Building 10-d, St George, UT 84770-4023 | 2007-05-23 |
| 1891907655 | Rodney L Andrus | Dentist | 640 E 700 S, Ste 104, St George, UT 84770-4023 | 2007-05-04 |
| 1619192861 | Advanced Pulmonary, Sleep Disorder and Internal Medicine,llc | Clinic/Center | 640 E 700 S, Suite 105, St George, UT 84770-4023 | 2007-04-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740808500 | Redstone Reference Laboratories Inc | Clinical Medical Laboratory | 556 N Dixie Drive, Suite 2, St George, UT 84770 | 2020-07-08 |
| 1033776315 | Ecko Ashmore | Marriage & Family Therapist | 1173 S. 250 W. Bld 1 Ste 208, St. George, UT 84770 | 2019-05-22 |
| 1740844679 | Amy Darragh | Behavior Technician | 249 E Tabernacle St, Ste 100, St George, UT 84770 | 2019-04-25 |
| 1124598198 | Loren Kyle Gulbranson | Internal Medicine | Dixie Regional Medical Center, 515 South, 300 East, Saint George, UT 84770 | 2018-12-03 |
| 1487150728 | Sound Sleep Medical LLC | Durable Medical Equipment & Medical Supplies | 640 East 700 South Building 2, St. George, UT 84770 | 2018-04-04 |
| 1588162911 | Desert Edge Medical | Family Medicine | 1664 S Dixie Dr Ste D201, St George, UT 84770 | 2018-01-31 |
| 1568981314 | Jeffrey Joseph Peterson | Behavior Technician | 162 N 400 E Ste A-105, St. George, UT 84770 | 2017-09-13 |
| 1992242549 | Zachary Carey | Specialist/Technologist | 1115 W Diamond Valley Dr, Saint George, UT 84770 | 2017-01-20 |
| 1669920427 | Charles Taylor Church | Technician, Other | 474 West 200 East, St. George, UT 84770 | 2016-09-21 |
| 1952755480 | Hollystic Hideaway | Voluntary or Charitable | 1418 W Sunset Blvd. # 2, Saint George, UT 84770 | 2016-04-21 |
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| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607589 | Trenton L Overall, Inc | Psychiatry & Neurology | 295 S 1470 E Ste 301, St George, UT 84790-1762 | 2020-10-23 |
| 1629596382 | Red Rock Neurology, LLC | Psychiatry & Neurology | 515 S 300 E Ste 107, St George, UT 84770-3931 | 2017-09-01 |
| 1306803226 | Laura Jean Schlagel | Psychiatry & Neurology | 2019 E Riverside Dr Ste A101, St George, UT 84790-8147 | 2006-04-26 |
| 1306284765 | Swati Laroia Coon | Psychiatry & Neurology | 652 S Medical Center Dr Ste 420, St George, UT 84790-7049 | 2013-06-07 |
| 1841575032 | Trenton Lee Overall | Psychiatry & Neurology | 652 S Medical Center Dr, 320, St George, UT 84790-7049 | 2011-10-19 |
| 1306081187 | Ihc Health Services Inc | Psychiatry & Neurology | 652 S Medical Center Dr, Ste 320, St George, UT 84790-7266 | 2008-12-09 |
| 1811175730 | Cordia Yuen Wan | Psychiatry & Neurology | 1380 E Medical Center Dr, St George, UT 84790-2123 | 2008-02-01 |
| 1497976864 | Taj N Becker | Psychiatry & Neurology | 736 S 900 E, 202, St George, UT 84790-7000 | 2007-05-01 |
| 1841219375 | Daniel Brennan Vine | Psychiatry & Neurology | 652 S Medical Center Dr, Ste 320, St George, UT 84790-7049 | 2006-07-18 |
| 1033175765 | Luciana De Saibro | Psychiatry & Neurology | 652 S Medical Center Dr, Suite 320, St George, UT 84790 | 2006-04-21 |
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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.