MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC (NPI# 1427075134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1427075134 |
Entity Type | Organization |
Organization Name | MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC |
Practice Address |
589 S State St Provo UT 84606-5056 |
Mailing Address |
589 South State Street Provo UT 84606-5056 |
Practice Telephone | 8014292000 |
Practice Fax Number | 8014292001 |
Mailing Telephone | 8014292000 |
Mailing Fax Number | 8014292001 |
Enumeration Date | 2006-07-17 |
Last Update Date | 2020-08-04 |
Authorized Official Name | MR. TODD BAILEY (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 8014292000 |
Authorized Official Credential | CMPE |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 122300000X | Dentist | Dental Providers | ||
N | 183500000X | Pharmacist | Pharmacy Service Providers | ||
N | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
Allopathic & Osteopathic Physicians | ||
N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437364882 | Mountainlands Community Health Center, Inc | Family Medicine | 910 E 100 N Ste 155, Payson, UT 84651-1638 | 2007-05-11 |
1699374496 | Mountainlands Community Health Center, Inc | Dentist | 299 E 900 S Ste 101, Provo, UT 84606-6107 | 2020-10-22 |
1144829946 | Mountainlands Community Health Center, Inc | Dentist | 589 S State St, Provo, UT 84606-5056 | 2020-10-22 |
1649879727 | Mountainlands Community Health Center, Inc | Dentist | 910 E 100 N Ste 155, Payson, UT 84651-1638 | 2020-10-20 |
Street Address |
589 S STATE ST |
City | PROVO |
State | UT |
Zip Code | 84606-5056 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144829946 | Mountainlands Community Health Center, Inc | Dentist | 589 S State St, Provo, UT 84606-5056 | 2020-10-22 |
1295347169 | Maria Dj Villagrana | Nurse Practitioner | 589 S State St, Provo, UT 84606-5056 | 2020-08-20 |
1932678307 | Sarah Gwendolyn Harmon Davis | Nurse Practitioner | 589 S State St, Provo, UT 84606-5056 | 2018-11-15 |
1003334525 | Kelly Marie Daly-wolfe | Physician Assistant | 589 S State St, Provo, UT 84606 | 2017-09-05 |
1497290555 | Elizabeth Anne Balle | Social Worker | 589 S State St, Provo, UT 84606-5056 | 2016-12-28 |
1639539521 | Leslie Divall | Midwife | 589 S State St, Provo, UT 84606-5056 | 2016-03-04 |
1871960823 | Verdon Reed Walker IIi | Physician Assistant | 589 S State St, Provo, UT 84606-5056 | 2015-08-25 |
1801223425 | Tyler David Sommer | Physician Assistant | 589 S State St, Provo, UT 84606-5056 | 2013-09-27 |
1902151954 | Stacy Ann Garnica | Nurse Practitioner | 589 S State St, Provo, UT 84606 | 2012-07-16 |
1871812370 | Mountainlands Family Pharmacy | Pharmacy | 589 S State St, Provo, UT 84606-5056 | 2010-05-24 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053935551 | Olivia Stiles | Specialist/Technologist | 200 E 515 N, Provo, UT 84606 | 2020-06-01 |
1417439076 | Quin Spencer Volpe | Counselor | 1035 E 560 N, Provo, UT 84606 | 2018-08-30 |
1700365434 | Hyunwook Lee | Specialist/Technologist | 1369 S 1500 E, Provo, UT 84606 | 2018-08-13 |
1598268930 | Victor Bert Arthur Moxley | Specialist | 290 N 300 E, Provo, UT 84606 | 2018-03-12 |
1184132623 | Academy Dental LLC | Advanced Practice Dental Therapist | 488 N 100 E St., Provo, UT 84606 | 2018-01-18 |
1720433485 | Sean Lamb | Counselor | 231 S. 100 E., Provo, UT 84606 | 2016-05-02 |
1508236795 | Forever Young Dentistry Pllc | Clinic/Center | 2335 S. State Street, Ste #200, Provo, UT 84606 | 2015-09-30 |
1558766014 | Nancy Huber | Physician Assistant | Mountainland Community Health Center, 529 South State Street, Provo, UT 84606 | 2014-10-27 |
1356778377 | Myrna Suzanne Gillis | Marriage & Family Therapist | 1726 Buckley Drive, Provo, UT 84606 | 2013-10-04 |
1558651067 | Melissa Anne Mccreary | Counselor | 151 S.state St. University Ave., Ste 1400, Provo, UT 84606 | 2011-04-18 |
Find all providers in zip 84606 |
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 |
---|---|---|---|---|
1407453160 | Utah Valley Natural Health Clinic | Family Medicine | 3311 N University Ave Ste 100, Provo, UT 84604-7432 | 2020-10-06 |
1750840054 | Jonathon Lee Gross | Family Medicine | 395 W Cougar Blvd Ste 205, Provo, UT 84604-3328 | 2019-03-16 |
1275099897 | Optimal Health Family Practice Pllc | Family Medicine | 75 S 200 E Ste 100, Provo, UT 84606-3146 | 2019-02-19 |
1518414481 | Ihc Health Services Inc | Family Medicine | 395 W Bulldog Blvd Ste 603, Provo, UT 84604 | 2016-09-08 |
1790175628 | Brigham Young University | Family Medicine | 173 Richards Building, Dance Department, Provo, UT 84602-2000 | 2015-01-30 |
1790198141 | Micia Roby | Family Medicine | 1055 N 500 W Building A, Provo, UT 84604 | 2014-06-03 |
1295171874 | Angel Kae Lybbert | Family Medicine | 395 W. Bulldog Blvd. Suite 6b, Provo, UT 84604 | 2013-05-22 |
1912267212 | Ihc Health Services Inc | Family Medicine | 1401 E 2000 S, Provo, UT 84606-2072 | 2012-05-21 |
1710250253 | Mark Timothy Ross | Family Medicine | 3737 N 970 E, Provo, UT 84604-5247 | 2012-02-14 |
1639497191 | John Frederic Templeman | Family Medicine | 4728 Mile High Dr, Provo, UT 84604-5318 | 2010-05-08 |
Find all providers in PROVO |
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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.