INTERMOUNTAIN HEALTHCARE (NPI# 1427456797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427456797 |
| Entity Type | Organization |
| Organization Name | INTERMOUNTAIN HEALTHCARE |
| Practice Address |
652 S Medical Center Dr Suite 120 St George UT 84790-7049 |
| Practice Telephone | 4352513600 |
| Practice Fax Number | 4356284469 |
| Mailing Telephone | 4352513600 |
| Mailing Fax Number | 4356284469 |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |
| Authorized Official Name | JENNIFER LEE TERRY (ATHLETIC TRAINER) |
| Authorized Official Telephone | 4352513600 |
| Authorized Official Credential | ATC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
8207030-4810 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790236446 | Intermountain Healthcare | General Acute Care Hospital | 821 Edgewood Dr, Ogden, UT 84403-4233 | 2016-10-18 |
| 1720445307 | Intermountain Healthcare | General Acute Care Hospital | 884 Black Rock Dr, Santa Clara, UT 84765-5440 | 2016-01-27 |
| 1144579616 | Intermountain Healthcare | General Acute Care Hospital | 5572 West Slate Canyon Drive, Apt B-101, West Jordan, UT 84081 | 2012-08-30 |
| 1346447331 | Intermountain Healthcare | General Acute Care Hospital | 8th Avenue and 'c' Street, Salt Lake City, UT 84143 | 2007-07-02 |
| 1942332465 | Intermountain Healthcare | General Acute Care Hospital | 4401 S Harrison Blvd, Mckay-dee, Ogden, UT 84403 | 2007-03-10 |
| 1821548702 | Intermountain Healthcare | Chronic Disease Hospital | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-10-04 |
| 1790230860 | Intermountain Healthcare | General Acute Care Hospital | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-08-18 |
| 1114378288 | Intermountain Healthcare | Clinic/Center | 3741 W 12600 S, Riverton, UT 84065-7215 | 2016-06-29 |
| 1316304918 | Intermountain Healthcare | Rehabilitation Hospital | 1034 N 500 W, Speech and Hearing, Provo, UT 84604-3380 | 2016-01-27 |
| 1316331523 | Intermountain Healthcare | Clinic/Center | 527 W 400 N Ste 2, Orem, UT 84057-1951 | 2015-03-25 |
| Street Address |
652 S MEDICAL CENTER DR SUITE 120 |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84790-7049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013916915 | Brookanne J Mickelson | Nurse Practitioner | 652 S Medical Center Dr, Ste 110, St George, UT 84790-7049 | 2005-07-21 |
| 1316561848 | Jacob Daniel Earl | Occupational Therapist | 652 S Medical Center Dr, St George, UT 84790-7049 | 2020-06-01 |
| 1013562875 | Alexa Atkin | Speech-Language Pathologist | 652 S Medical Center Dr, St George, UT 84790-7049 | 2019-08-07 |
| 1265090039 | Kelli D Reese | Speech-Language Pathologist | 652 S Medical Center Dr, St George, UT 84790-7049 | 2019-06-05 |
| 1932666781 | Health Services Inc | Preventive Medicine | 652 S Medical Center Dr, St George, UT 84790-7049 | 2019-02-28 |
| 1134683774 | Michelle Lynn Schierl | Occupational Therapist | 652 S Medical Center Dr, St George, UT 84790-7049 | 2019-01-28 |
| 1871067090 | Danielle Marie Smith | Hospitalist | 652 S Medical Center Dr, St George, UT 84790-7049 | 2019-01-22 |
| 1942733126 | David Scott Foisy | Nurse Practitioner | 652 S Medical Center Dr, St George, UT 84790-7049 | 2017-04-05 |
| 1588119622 | Kashae Anderson | Physician Assistant | 652 S Medical Center Dr, Ste 420, St George, UT 84790-7049 | 2016-08-18 |
| 1265887343 | Michelle Hudson | Specialist/Technologist | 652 S Medical Center Dr, St George, UT 84790-7049 | 2016-04-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342713 | Katrina Poulsen | Student in an Organized Health Care Education/Training Program | 617 East Rriverside Dr, Ste 301, St. George, UT 84790 | 2020-10-08 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1366066417 | Benjamin Todd Lloyd | Dentist | 1683 E. Wolf Hole Dr, St. George, UT 84790 | 2020-06-04 |
| 1801434584 | Jennifer M Putnam | Marriage & Family Therapist | 321 North Mall Drive, Vw103, St. George, UT 84790 | 2019-12-12 |
| 1326683012 | Red Mountain Counseling and Education | Counselor | 321 No Mall Dr, Vw 103, St. George, UT 84790 | 2019-11-17 |
| 1295376002 | Karynne Kimberly Simpson | Behavior Technician | 280 N 1680 E U1, St. George, UT 84790 | 2019-10-02 |
| 1962053017 | Mikala Larsen | Nurse Practitioner | 1380 S Medical Center Dr., Saint George, UT 84790 | 2019-09-20 |
| 1326690678 | Joe Ballent | Student in an Organized Health Care Education/Training Program | 1526 S Medical Center Dr Ste 224a, St George, UT 84790 | 2019-07-16 |
| 1558923854 | David Pace | Optometrist | 749 South River Rd, St. George, UT 84790 | 2019-07-08 |
| 1639734924 | Mariah Ann Mertlich | Behavioral Analyst | 280 N 1680 E, U1, St. George, UT 84790 | 2019-05-02 |
| Find all providers in zip 84790 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578985438 | Emere Utah LLC | Orthopaedic Surgery | 1490 E Foremaster Dr, Suite 260, St George, UT 84790-4488 | 2014-01-13 |
| 1649426800 | Ihc Health Services Inc | Orthopaedic Surgery | 652 S Medical Center Dr, #ll20, St George, UT 84790-0000 | 2008-08-07 |
| 1104953652 | Ihc Health Services Inc | Orthopaedic Surgery | 652 S Medical Center Dr, Suite 400, St George, UT 84790-7017 | 2007-02-28 |
| 1356384226 | Michael Richard Green | Orthopaedic Surgery | 1490 E Foremaster Dr, # 260, St George, UT 84790-4488 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811265044 | Lonnie Paulos Md PC | Orthopaedic Surgery | 324 East 10th Avenue, Ste 172, Salt Lake City, UT 84103-3184 | 2011-12-02 |
| 1477865491 | Ihc Health Services Inc | Orthopaedic Surgery | 1159 E 200 N Ste 100, American Fork, UT 84003-2053 | 2010-07-07 |
| 1558546739 | Mark A.rosen Md, LLC | Orthopaedic Surgery | 5911 Fashion Blvd., Suite 100, Murray, UT 84107 | 2008-01-07 |
| 1255422192 | Bruce E Thomas | Orthopaedic Surgery | 5957 Fashion Point Dr, Suite 101, Ogden, UT 84403-5180 | 2006-09-27 |
| 1922098334 | Eric A Heiden | Orthopaedic Surgery | 2200 Park Ave Bldg D, Park City, UT 84060-7246 | 2005-10-26 |
| 1487646998 | Robert B Bourne | Orthopaedic Surgery | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2005-08-19 |
| 1992700330 | Leon E Paulos | Orthopaedic Surgery | 324 10th Ave, Suite 175, Salt Lake City, UT 84103-2853 | 2005-06-14 |
| 1366917577 | Kevin Dale Newbold | Orthopaedic Surgery | 3895 Harrison Blvd, Ogden, UT 84403-2312 | 2018-10-04 |
| 1588162283 | Alpine Management and Consulting | Orthopaedic Surgery | 2310 N 400 E Ste A, Logan, UT 84341-1796 | 2018-01-28 |
| 1083128730 | Kia Wilson | Orthopaedic Surgery | 375 S Chipeta Way, Salt Lake City, UT 84108-1260 | 2017-11-16 |
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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.