MAT VENTURES (NPI# 1467089607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467089607 |
| Entity Type | Organization |
| Organization Name | MAT VENTURES |
| Practice Address |
8388 S Wasatch Blvd Cottonwood Heights UT 84121-6075 |
| Mailing Address |
Po Box 639 Draper UT 84020-0601 |
| Practice Telephone | 8015586564 |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2020-03-26 |
| Authorized Official Name | COREY MARKISICH (OWNER) |
| Authorized Official Telephone | 8015586564 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | MAT VENTURES INC | 100 Main St, White Plains, New York 10601 |
| Street Address |
8388 S WASATCH BLVD |
| City | COTTONWOOD HEIGHTS |
| State | UT |
| Zip Code | 84121-6075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407483522 | Kaitlyn Horne | Behavior Technician | 6910 S. Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-26 |
| 1952936387 | Jared Wells | Behavior Technician | 6910 S Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-05 |
| 1518591874 | Slc Plastic Surgery LLC | Plastic Surgery | 6686 Highland Drive, Cottonwood Heights, UT 84121 | 2020-02-26 |
| 1093273708 | Anna O'hearon | Counselor | New Roads Behavioral Health, 2450 Fort Union Blvd, Cottonwood Heights, UT 84121 | 2019-03-12 |
| 1053883181 | Charles Keller IIi | Pediatrics | 2198 S Yvonne Rd #344, Salt Lake City, UT 84121 | 2018-12-31 |
| 1669964516 | Marissa King | Specialist | 1141 E. 3900 S. Suite 150a, Salt Lake, UT 84121 | 2018-06-05 |
| 1376044313 | Slpd Cottonwood LLC | Dentist | 7167 South Highland Drive, 200, Cottonwood Heights, UT 84121 | 2018-02-26 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1912430588 | Wasatch Midwifery and Wellness, LLC | Dietitian, Registered | 6440 S Wasatch Blvd, Ste 140, Holladay, UT 84121 | 2017-04-10 |
| 1407308331 | Tina Polgar | Registered Nurse | 6244 Highland Drive, Murray, UT 84121 | 2016-10-26 |
| Find all providers in zip 84121 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1033742994 | Mobile Vivitrol | Family Medicine | 46 N Foxhill Rd, North Salt Lake, UT 84054-3027 | 2020-02-19 |
| 1518516210 | Cuicui Zhang | Family Medicine | 8686 S 1300 E # L102l104, Sandy, UT 84094-1947 | 2019-09-05 |
| 1275034084 | Southern Utah Health & Recovery | Family Medicine | 260 W Saint George Blvd Ste 202b, St George, UT 84770-3792 | 2018-02-27 |
| 1003070111 | Robert Joel Bush | Family Medicine | 74 S 360 E, American Fork, UT 84003 | 2008-07-17 |
| 1376577049 | Sean Anthony Ponce | Family Medicine | 3802 S 700 E, Salt Lake City, UT 84106-1182 | 2006-07-10 |
| 1538114889 | Daniel Clyde Cummings | Family Medicine | 694 N 1890 W Unit 44a, Provo, UT 84601-1327 | 2006-05-24 |
| 1457355869 | Charles Wesley Walton | Family Medicine | 11286 N Tamarack Dr, Highland, UT 84003-9595 | 2005-06-13 |
| 1174136113 | Amir Haskic | Family Medicine | 2870 E 3300 S, Salt Lake City, UT 84109-2821 | 2020-08-28 |
| 1598267122 | Utah Addiction Medicine | Family Medicine | 619 N 500 W, Provo, UT 84601-1547 | 2018-02-28 |
| Find all providers with the same taxonomy | ||||
| City | COTTONWOOD HEIGHTS |
| Zip Code | 84121 |
Please comment or provide details below to improve the information on MAT VENTURES.
| 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.