UTAH PODIATRY GROUP PC (NPI# 1457737579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457737579 |
| Entity Type | Organization |
| Organization Name | UTAH PODIATRY GROUP PC |
| Other Organization Name | ADVANCED FOOT & ANKLE CENTER |
| Practice Address |
1973 North State Street Provo UT 84604-1012 |
| Mailing Address |
Po Box 30015 Dept 380 Salt Lake City UT 84130-0015 |
| Practice Telephone | 8013732499 |
| Practice Fax Number | 8013735200 |
| Mailing Telephone | 8013732499 |
| Mailing Fax Number | 8013735200 |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2020-04-21 |
| Authorized Official Name | SUSAN MARIE TAYLOR (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8015050821 |
| Is Organization Subpart | Y |
| Parent Organization Name | UTAH PODIATRY GROUP PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | DME PTAN | 6152070001 | 01 |
| Other Name | Type Code |
|---|---|
| Advanced Foot & Ankle Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700369014 | Utah Podiatry Group PC | Podiatrist | 6321 S Redwood Rd Ste 102, Taylorsville, UT 84123-6799 | 2018-09-12 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| 1972875524 | Utah Podiatry Group PC | Podiatrist | 2159 S 700 E Ste 150, Salt Lake City, UT 84106 | 2012-01-29 |
| 1659991438 | Utah Podiatry Group PC | Podiatrist | 3435 E Pony Express Pkwy Ste 140, Eagle Mountain, UT 84005-5548 | 2020-04-21 |
| 1942733415 | Utah Podiatry Group PC | Podiatrist | 345 W 600 S, Ste 408, Heber City, UT 84032-2247 | 2017-04-11 |
| 1598205494 | Utah Podiatry Group PC | Podiatrist | 440 Medical Dr, Ste 1, Bountiful, UT 84010-4950 | 2017-02-27 |
| 1831575760 | Utah Podiatry Group PC | Podiatrist | 48 W 1500 N, Nephi, UT 84648-8900 | 2015-08-03 |
| 1023404514 | Utah Podiatry Group PC | Podiatrist | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2015-04-10 |
| 1093081101 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E, Suite 301, Salt Lake City, UT 84102 | 2012-03-23 |
| Street Address |
1973 NORTH STATE STREET |
| City | PROVO |
| State | UT |
| Zip Code | 84604-1012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588664759 | Jared T Clegg | Podiatrist | 1973 North State Street, Provo, UT 84604-1012 | 2005-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295001683 | Cascade Foot and Ankle Clinic PC | Podiatrist | 1973 North State St, Provo, UT 84604-5711 | 2012-03-29 |
| 1942338496 | Cascade Foot and Ankle Clinic PC | Podiatrist | 1973 N State St, Provo, UT 84604-5711 | 2007-02-28 |
| 1790726487 | H Gary Morley | Podiatrist | 1275 N University Ave, Suite 12, Provo, UT 84604-7123 | 2006-06-10 |
| 1326428061 | Garr Foot & Ankle Pllc | Podiatrist | 1355 N University Ave, Ste 125, Provo, UT 84604-2721 | 2015-06-08 |
| 1215315817 | Todd Joseph Jaramillo | Podiatrist | 3355 N University Ave Ste 175, Provo, UT 84604 | 2015-05-14 |
| 1285980094 | Randy Garr | Podiatrist | 1355 N University Ave, Ste 125, Provo, UT 84604-2721 | 2012-07-30 |
| 1881729507 | Central Utah Foot Clinic, LLC | Podiatrist | 150 W 800 N, Provo, UT 84601-1624 | 2007-02-22 |
| 1356416770 | Rocky Mountain Foot and Ankle Clinic | Podiatrist | 777 N 500 W, Suite 105, Provo, UT 84601-1541 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033721303 | Stride Foot and Ankle Pllc | Podiatrist | 1365 W 1250 S Ste 101, Orem, UT 84058-2303 | 2020-08-18 |
| 1700369014 | Utah Podiatry Group PC | Podiatrist | 6321 S Redwood Rd Ste 102, Taylorsville, UT 84123-6799 | 2018-09-12 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| 1447773122 | Apex Foot and Ankle Institute | Podiatrist | 882 N Main St # 2, Richfield, UT 84701-1840 | 2017-07-25 |
| 1902328644 | Weston Charles Packard | Podiatrist | 1561 W 7000 S Ste 201, West Jordan, UT 84084-3556 | 2017-07-14 |
| 1053844753 | Elite Ankle and Foot Pllc | Podiatrist | 39 E Center Street, Gunnison, UT 84634 | 2017-04-10 |
| 1811341621 | Victor Kent Myers | Podiatrist | 754 S Main St Ste 3, St George, UT 84770-5505 | 2016-04-18 |
| 1598119463 | Landon Cameron | Podiatrist | 1490 E Foremaster Dr Ste 250, St George, UT 84790-4501 | 2016-04-18 |
| 1417338161 | Adam Bowen Wood | Podiatrist | 1248 E 90 N Ste 101, American Fork, UT 84003-2954 | 2015-06-17 |
| Find all providers with the same taxonomy | ||||
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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.