INTERVENTIONAL MEDICAL CENTER (NPI# 1558871590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558871590 |
| Entity Type | Organization |
| Organization Name | INTERVENTIONAL MEDICAL CENTER |
| Other Organization Name | INTERVENTIONAL MEDICAL CENTER |
| Practice Address |
1972 W 5400 S Taylorsville UT 84129-1459 |
| Mailing Address |
32 W Winchester St Ste 100 Murray UT 84107-5609 |
| Practice Telephone | 8019988256 |
| Practice Fax Number | 8018490340 |
| Mailing Telephone | 8019988256 |
| Mailing Fax Number | 8018490340 |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2017-10-24 |
| Authorized Official Name | MRS. JENNIE N NGUYEN (MANAGER) |
| Authorized Official Telephone | 8016793488 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| INTERVENTIONAL MEDICAL CENTER | Doing Business As Name - Organization |
| Street Address |
1972 W 5400 S |
| City | TAYLORSVILLE |
| State | UT |
| Zip Code | 84129-1459 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821028861 | Roman D. Hentish | Chiropractor | 1972 W 5400 S, Taylorsville, UT 84118-1459 | 2006-07-04 |
| 1932738028 | Mind and Body Integration | Clinic/Center | 1972 W 5400 S, Taylorsville, UT 84129-1459 | 2020-04-02 |
| 1598285025 | Lacey J Peterson | Social Worker | 1972 W 5400 S, Taylorsville, UT 84129-1459 | 2017-06-26 |
| 1205237799 | Rachel Jenkins-lloyd | Nurse Practitioner | 1972 W 5400 S, Taylorsville, UT 84129-1459 | 2014-09-16 |
| 1528327137 | Upri Taylorsville | Specialist | 1972 W 5400 S, Suite 100, Taylorsville, UT 84129-1459 | 2012-05-16 |
| 1629231287 | Watts LLC | Chiropractor | 1972 W 5400 S, Taylorsville, UT 84118-1459 | 2008-07-03 |
| 1336294602 | Healthquest of Taylorsville | Chiropractor | 1972 W 5400 S, Taylorsville, UT 84118-1459 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891140331 | Caring for Kearns | Social Worker | 5525 S 4015 W, Suite #207 A & B, Taylorsville, UT 84129 | 2016-05-03 |
| 1386014116 | Rusty Scott Burns | Physician Assistant | 4745 South 3200 West, Oquirrh View Clinic, Taylorsville, UT 84129 | 2015-10-06 |
| 1013398817 | Clifford Simpson | Counselor | 4897 S Avant Cir, Taylorsville, UT 84129 | 2015-06-17 |
| 1912328576 | Heather Jenkins | Substance Abuse Rehabilitation Facility | 6200 South 3809 West, Kearns, UT 84129 | 2013-12-30 |
| 1184981201 | Intermountain Community Supports and Services, LLC | In Home Supportive Care | 5104 Heritage Cove, Taylorsville, UT 84129 | 2012-04-13 |
| 1093039521 | Chad Alan Spain | Family Medicine | 3745 West 4700 South, Family Practice, Taylorsville, UT 84129 | 2010-03-26 |
| 1396068342 | Lindsay Helena Wilson | Dermatology | 3845 West 4700 South, Intermountain Healthcare Taylorsville Clinic, Taylorsville, UT 84129 | 2010-03-04 |
| 1962962407 | Craig J Campbell Dpm PC | Durable Medical Equipment & Medical Supplies | 5255 S 4015 W, #140, Salt Lake City, UT 84129 | 2019-03-21 |
| 1851866735 | Katie Nicholls | Physician Assistant | 4745 S 3200 W, Taylorsville, UT 84129 | 2018-10-08 |
| 1962829374 | Spencer Tingey | Family Medicine | 3730 W 4700 S, Taylorsville, UT 84129 | 2014-03-24 |
| Find all providers in zip 84129 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043819600 | Devin J Morrison | Peer Specialist | 230 W 200 S Unit 142, Salt Lake City, UT 84110-6006 | 2020-10-23 |
| 1104423532 | Chante Colvin | Peer Specialist | 3638 Sugar Leo Rd, St George, UT 84790-7452 | 2020-10-08 |
| 1518579077 | Henry Matthews | Peer Specialist | 474 N Grant St, Salt Lake City, UT 84116-2726 | 2020-08-17 |
| 1508497892 | Jamie Len Griffin | Peer Specialist | 256 W 100 S, Logan, UT 84321-5231 | 2020-01-27 |
| 1295370013 | Amber Chandler | Peer Specialist | 15257 S Scenic Crest Cir, Bluffdale, UT 84065-5076 | 2019-11-15 |
| 1780232272 | Billie Jo Burnett | Peer Specialist | 1429 N 1200 W, Orem, UT 84057-2449 | 2019-08-28 |
| 1669025227 | Ryan Ballard | Peer Specialist | 589 E 8680 S, Sandy, UT 84070-1779 | 2019-07-22 |
| 1134780042 | Michael James Olsen | Peer Specialist | 344 E 100 S Ste 301300, Salt Lake City, UT 84111-1700 | 2019-06-23 |
| 1659836393 | Brittney Emi Vaovasa | Peer Specialist | 252 W Brooklyn Ave, Salt Lake City, UT 84101-3024 | 2019-02-06 |
| 1699278366 | John Carlos Gonzales | Peer Specialist | 7873 S Chadbourne Dr, Cottonwood Heights, UT 84121-5806 | 2018-03-08 |
| Find all providers with the same taxonomy | ||||
| City | TAYLORSVILLE |
| Zip Code | 84129 |
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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.