SHADOW MOUNTAIN FAMILY PHYSICIANS (NPI# 1417125139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417125139 |
| Entity Type | Organization |
| Organization Name | SHADOW MOUNTAIN FAMILY PHYSICIANS |
| Practice Address |
7800 South 3855 West 100 West Jordan UT 84088 |
| Mailing Address |
7800 S 3855 W #100 West Jordan UT 84084 |
| Practice Telephone | 8012825952 |
| Practice Fax Number | 8012825951 |
| Mailing Telephone | 8012825952 |
| Mailing Fax Number | 8012825951 |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2008-04-01 |
| Authorized Official Name | DR. JOSEPH KASPER (PRESIDENT) |
| Authorized Official Telephone | 8012825952 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 346744-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
7800 SOUTH 3855 WEST 100 |
| City | WEST JORDAN |
| State | UT |
| Zip Code | 84088 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881178655 | Sierra Burt | Physician Assistant | 3584 West 90000 South Suite 304, West Jordan, UT 84088 | 2018-09-18 |
| 1659861847 | Miller Anesthesia Consultants PC | Anesthesiology | Jvmc Dept. of Anesthesiology, 3580 W. 9000 S., West Jordan, UT 84088 | 2018-05-14 |
| 1821501495 | Cleo Stephanides Cheney | Dentist | 8846 South Redwood Rd., Suite N201, West Jordan, UT 84088 | 2017-11-06 |
| 1124546742 | Crystal Lynn Santos | Counselor | 4431 8200 S, West Jordan, UT 84088 | 2017-09-04 |
| 1154705960 | Heston Farnsworth | Dentist | 9217 South Redwood Road, Suite B, West Jordan, UT 84088 | 2015-07-13 |
| 1750778767 | Andrew Cantwell | Dentist | 3855 7800 South #150, West Jordan, UT 84088 | 2015-04-17 |
| 1962764282 | Steven Howard Reano | Specialist | 8789 S Redwood Road, Ste 100, West Jordan, UT 84088 | 2012-06-12 |
| 1528328846 | Orthodontic Payment Services, LLC | Dentist | 1231 W 9000 S #d, West Jordan, UT 84088 | 2012-05-21 |
| 1588932321 | Jessica Millard | Counselor | 9278 S 1700 W, West Jordan, UT 84088 | 2011-12-08 |
| 1346553062 | Barbara Rouse | Counselor | 9278 Redwood Rd, West Jordan, UT 84088 | 2010-07-22 |
| Find all providers in zip 84088 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689210551 | Evergreen Clinic LLC | Family Medicine | 1561 W 7000 S Ste 100, West Jordan, UT 84084-3556 | 2019-11-25 |
| 1528203817 | West Jordan Family Medicine, LLC | Family Medicine | 6783 S Redwood Rd Ste 103, West Jordan, UT 84084-5685 | 2008-12-16 |
| 1962606657 | Jordan Landing Family Medicine LLC | Family Medicine | 3895 W 7800 S Suite 100, West Jordan, UT 84088-1966 | 2007-06-14 |
| 1336227206 | Jackie Anne Fonua | Family Medicine | 3354 W 7800 S, West Jordan, UT 84088-4506 | 2006-11-01 |
| 1235158304 | Brenten C Pugh, Md | Family Medicine | 3895 W 7800 S Ste 100, West Jordan, UT 84088-5616 | 2006-07-19 |
| 1174555320 | James S Coy | Family Medicine | 2751 W 9000 S, West Jordan, UT 84088 | 2006-07-07 |
| 1386675627 | Randall R Fillmore | Family Medicine | 2751 W 9000 South, West Jordan, UT 84088 | 2006-07-05 |
| 1568405397 | Dennis R Hamp | Family Medicine | 3895 W 7800 S, Suite, 100, West Jordan, UT 84088-5617 | 2006-06-13 |
| 1275576027 | Judith L Kirstein | Family Medicine | 8846 S Redwood Rd, Ste E121, West Jordan, UT 84088-9334 | 2006-06-13 |
| 1952341000 | Randall L. Watson | Family Medicine | 1575 W 7000 S, West Jordan, UT 84084-3431 | 2006-06-07 |
| Find all providers in WEST JORDAN | ||||
| City | WEST JORDAN |
| Zip Code | 84088 |
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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.