TOOELE UROLOGY LLC (NPI# 1457599912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457599912 |
| Entity Type | Organization |
| Organization Name | TOOELE UROLOGY LLC |
| Practice Address |
11179 Ivy Creek Cv South Jordan UT 84095-2249 |
| Practice Telephone | 8018222727 |
| Mailing Telephone | 8018222727 |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2019-09-25 |
| Authorized Official Name | DR. DAN HIBBERT (MANAGER) |
| Authorized Official Telephone | 8018222727 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | UROLOGIC SURGERY ASSOCIATES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QL0400X |
Clinic/Center Specialization: Lithotripsy |
7100427-1205 | UT | Ambulatory Health Care Facilities |
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
7100427-1205 | UT | Ambulatory Health Care Facilities |
| Street Address |
11179 IVY CREEK CV |
| City | SOUTH JORDAN |
| State | UT |
| Zip Code | 84095-2249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588802961 | Urologic Surgery Associates | Clinic/Center | 11179 Ivy Creek Cv, South Jordan, UT 84095-2249 | 2009-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033745393 | Beverly Laraine Williams | Social Worker | 11260 S River Heights Drive, South Jordan, UT 84095 | 2020-03-19 |
| 1265902902 | Sarah Richele Kelley | Specialist/Technologist | 10236 Alder Grovey Way, South Jordan, UT 84095 | 2018-11-26 |
| 1326528837 | Kristi Couse | Massage Therapist | 10679 S 2200 W Apt 2, South Jordan, UT 84095 | 2018-08-15 |
| 1821516063 | River Crossing Dental Professional Corporation | Clinic/Center | 12427 South 4000 West, Suite #200, Riverton, UT 84095 | 2017-09-08 |
| 1245755719 | Staci Stout | Dental Hygienist | 3113 W Swiss Pass Cir, South Jordan, UT 84095 | 2017-08-07 |
| 1437698750 | Ryan Sears | Dentist | 10894 So. River Front Parkway, South Jordan, UT 84095 | 2017-02-20 |
| 1366989931 | Ultimate Sports Regenerative Medicine | Chiropractor | 1098 W. South Jordan Pkwy, Suite 101, South Jordan, UT 84095 | 2017-01-20 |
| 1306393889 | Tal Quirl | Optometrist | 3571 W. 10400 S., South Jordan, UT 84095 | 2016-09-01 |
| 1023562667 | Sevon Taroian | Social Worker | 11260 River Heights Drive, South Jordan, UT 84095 | 2016-08-11 |
| 1952762932 | Megan Buckley | Developmental Therapist | 881 Baxter Drive, Ste 100, South Jordan, UT 84095 | 2016-03-17 |
| Find all providers in zip 84095 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| 1417596339 | Adams Chiropractic Inc. | Clinic/Center | 3336 S Pioneer Pkwy Ste 202, West Valley City, UT 84120-2080 | 2019-12-23 |
| 1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
| 1497316905 | The West Clinic Draper | Clinic/Center | 12371 S 900 E, Draper, UT 84020-9833 | 2019-06-25 |
| 1235691510 | Desert Bloom Plastic Surgery LLC | Clinic/Center | 446 S Mall Dr Ste 1, St George, UT 84790-4944 | 2019-04-04 |
| 1568952190 | Bear River Valley Medical LLC | Clinic/Center | 9825 N 10800 W, Tremonton, UT 84337-9222 | 2018-05-18 |
| 1376944942 | Legacy Dermatology | Clinic/Center | 320 W 500 S, Suite 210, Bountiful, UT 84010-7218 | 2014-09-14 |
| 1821417684 | James E Wellman Md | Clinic/Center | 5998 Spring Canyon Rd, Ogden, UT 84403-5476 | 2014-04-09 |
| 1255769386 | Slc Diagnostic Imaging | Clinic/Center | 6202 W Freedom Hill Way, Herriman, UT 84096-6987 | 2013-10-29 |
| 1013269406 | Cnm | Clinic/Center | 4749 S Holladay Blvd, Holladay, UT 84117-5420 | 2012-10-09 |
| 1023381241 | Clifford G Harman | Clinic/Center | 12091 Lampton View Dr, Riverton, UT 84065-7834 | 2012-02-18 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH JORDAN |
| Zip Code | 84095 |
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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.