ASHLEY VALLEY PHYSICIAN PRACTICE, LLC (NPI# 1518247709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518247709 |
| Entity Type | Organization |
| Organization Name | ASHLEY VALLEY PHYSICIAN PRACTICE, LLC |
| Other Organization Name | ROOSEVELT COMMUNITY CLINIC |
| Practice Address |
409 S 200 E Roosevelt UT 84066-3314 |
| Practice Telephone | 4357253327 |
| Practice Fax Number | 4357253331 |
| Mailing Telephone | 4357253327 |
| Mailing Fax Number | 4357253331 |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2020-09-03 |
| Authorized Official Name | KATHY TEAGUE (ASST VICE PRESIDENT, SECRETARY) |
| Authorized Official Telephone | 6159207000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Roosevelt Community Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689008773 | Ashley Valley Physician Practice, LLC | Occupational Therapist | 1680 W Highway 40 Ste 202, Vernal, UT 84078 | 2013-08-26 |
| 1740482025 | Ashley Valley Physician Practice, LLC | Family Medicine | 175 N. 100 W., Suite 202, Vernal, UT 84078 | 2007-05-31 |
| 1952631400 | Ashley Valley Physician Practice, LLC | Internal Medicine | 150 W 100 N, Vernal, UT 84078-2036 | 2010-01-06 |
| 1790010619 | Ashley Valley Physician Practice, LLC | Surgery | 150 W 100 N, Suite 102s, Vernal, UT 84078-2036 | 2009-10-09 |
| 1740423367 | Ashley Valley Physician Practice, LLC | Urology | 150 W 100 N, Vernal, UT 84078-2036 | 2009-04-13 |
| Street Address |
409 S 200 E |
| City | ROOSEVELT |
| State | UT |
| Zip Code | 84066-3314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871834960 | Ashley Valley Physician Practice LLC | Clinic/Center | 409 S 200 E, Roosevelt, UT 84066-3314 | 2013-03-14 |
| 1013297142 | Sarah Heaton | Physician Assistant | 409 S 200 E, Roosevelt, UT 84066-3314 | 2011-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477075315 | Annemarie Rousseau | Registered Nurse | 250 West 300 North, Roosevelt, UT 84066 | 2017-07-12 |
| 1780036772 | Drew Gilley | Dentist | 375 E Lagoon St, Roosevelt, Ut 84066, Roosevelt, UT 84066 | 2016-07-01 |
| 1952758039 | Amanda Adams | Massage Therapist | 1151 East Hwy 40, Ballard, UT 84066 | 2016-05-19 |
| 1447624325 | Gregory George Page | Dentist | 209 West 200 North 71-2, Roosevelt, UT 84066 | 2015-11-16 |
| 1659785772 | Becky Ann Birch | Nurse Practitioner | 200 West 350 North, Ste 103, Roosevelt, UT 84066 | 2014-06-17 |
| 1760724280 | Novo Ranch LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3549 W 1000 North, Roosevelt, UT 84066 | 2013-03-22 |
| 1508110040 | Uintah Basin Spine and Disc Center, PC | Rehabilitation Unit | 1151 East Highway 40, Roosevelt, UT 84066 | 2012-11-06 |
| 1184918682 | Alvaro Beltran | Dentist | Ave. Lopez Mateos 171-4, Nogales, SONORA 84066 | 2011-06-02 |
| 1255638367 | Cosme Cantu | Dentist | Blvd. El Greco #45 Int. J-14, Nogales, SONORA 84066 | 2011-02-25 |
| 1740482009 | Northeastern Utah Medical Group | Durable Medical Equipment & Medical Supplies | 210 W 300 N 75 3, Roosevelt, UT 84066 | 2007-05-31 |
| Find all providers in zip 84066 | ||||
| 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 |
|---|---|---|---|---|
| 1003145285 | Terry Mackley Buxton | Family Medicine | 1059 W 200 N # 58-6, Roosevelt, UT 84066-2633 | 2009-12-16 |
| 1831359744 | John Spencer Wells | Family Medicine | 250 W 300 N, Roosevelt, UT 84066-2336 | 2008-06-13 |
| 1699942987 | Jeffrey Lynn Wheeler | Family Medicine | 250 W 300 N, Roosevelt, UT 84066-2336 | 2008-05-15 |
| 1174703516 | Tarika Shareen James | Family Medicine | 380 Nassau Rd, Roosevelt, NY 11575-1343 | 2007-11-13 |
| 1811910359 | Gary F Graham | Family Medicine | 210 W 300 N, Roosevelt, UT 84066-2336 | 2006-07-25 |
| 1205897196 | Gary B White | Family Medicine | 210 W 300 N, 75-3, Roosevelt, UT 84066-2336 | 2006-03-30 |
| 1629037072 | Emilio Garcia | Family Medicine | 380 Nassau Rd, Long Island Fqhc, Inc., Roosevelt, NY 11575-1343 | 2006-03-22 |
| 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 |
| 1528665411 | Rejuvaroom LLC | Family Medicine | 954 N 200 E, Spanish Fork, UT 84660-1247 | 2020-10-05 |
| 1356957468 | Aubrie Dawn Tilley | Family Medicine | 1741 E Imperial Park Ln, Salt Lake City, UT 84106-3379 | 2020-09-23 |
| 1588274013 | Jack L Cox | Family Medicine | 1588 N Dutch Meadows Ln, Midway, UT 84049-1275 | 2020-08-10 |
| 1457969834 | Sandra Lee Porter | Family Medicine | 3979 S Jester Dr, Salt Lake City, UT 84123-1227 | 2020-07-21 |
| 1265057673 | Onsite Care Clinics | Family Medicine | 230 S 500 E Ste 510, Salt Lake City, UT 84102-2028 | 2020-06-11 |
| 1154942985 | Healing Center of Utah | Family Medicine | 2630 W 3500 S Ste B, West Valley City, UT 84119-3113 | 2020-05-04 |
| 1649805813 | Hilorie Edwards Garside | Family Medicine | 3024 W 300 N Ste 3, West Point, UT 84015-7258 | 2020-03-09 |
| 1417595497 | Regenerative Medicine of Utah, LLC | Family Medicine | 2297 N Hill Field Rd Ste 101, Layton, UT 84041-6927 | 2019-12-20 |
| 1871131623 | In Home Provider | Family Medicine | 2432 Concord Ave, Santa Clara, UT 84765-5621 | 2019-12-11 |
| 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.