WHITNEY MACK (NPI# 1598173403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598173403 |
| Entity Type | Individual |
| Full Name | WHITNEY MACK |
| Practice Address |
476 Williams Way Moab UT 84532-2186 |
| Mailing Address |
450 Williams Way Moab UT 84532-2185 |
| Practice Telephone | 4357193500 |
| Mailing Telephone | 4357193500 |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2020-07-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 10869093-1204 | UT | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 125065213 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 450 Williams Way, Moab, UT 845322185 | 4357193500 |
| Street Address |
476 WILLIAMS WAY |
| City | MOAB |
| State | UT |
| Zip Code | 84532-2186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023091931 | Kenneth Lewis Williams | Family Medicine | 476 Williams Way, Ste A, Moab, UT 84532-2065 | 2005-11-23 |
| 1346854130 | Scl Health Medical Group - Grand Junction, LLC | Internal Medicine | 476 Williams Way, Moab, UT 84532-2186 | 2020-08-31 |
| 1356636609 | Dylan Cole | Family Medicine | 476 Williams Way, Suite A, Moab, UT 84532-2065 | 2011-06-15 |
| 1205142924 | Keely Fitzgerald Hanson | Physician Assistant | 476 Williams Way, Suite A, Moab, UT 84532-2186 | 2010-08-19 |
| 1851461339 | Lionel Edwards Weeks | Orthopaedic Surgery | 476 Williams Way, Moab, UT 84532-2065 | 2006-11-09 |
| 1902917438 | Nicole Lee Priest | Family Medicine | 476 Williams Way, Ste A, Moab, UT 84532-2065 | 2006-08-31 |
| 1528070489 | Moab Family Medicine PC | Family Medicine | 476 Williams Way, A, Moab, UT 84532-2065 | 2006-08-12 |
| 1780638973 | Melinda J Stanford | Nurse Practitioner | 476 Williams Way, Moab, UT 84532-2065 | 2006-05-20 |
| 1669455580 | Katherine Kallmeyer Williams | Family Medicine | 476 Williams Way, Ste A, Moab, UT 84532-2065 | 2005-11-23 |
| 1801879721 | Jonas Seth Munger | Family Medicine | 476 Williams Way, Ste A, Moab, UT 84532-2065 | 2005-11-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386254316 | Andrew Soliz II | Case Manager/Care Coordinator | 48 N Shields Lane, Moab, UT 84532 | 2020-08-04 |
| 1023655420 | William Douglas Wennell | Registered Nurse | 198 E. Center St., Moab, UT 84532 | 2019-12-04 |
| 1295219962 | Jordan Johnson | Case Manager/Care Coordinator | 48 N. Shields Lane, Moad, UT 84532 | 2018-09-19 |
| 1659851681 | Grand County Emergency Medical Services Special Service District | Ambulance | 520 E 100 N, Moab, UT 84532 | 2018-08-20 |
| 1265937072 | Byron Clifton Palmer | Dentist | 2700 Us-191, Suite 1, Moab, UT 84532 | 2018-03-26 |
| 1902290588 | Katherine O'reilly | Advanced Practice Midwife | 51 North Mt.peale, Moab, UT 84532 | 2015-03-23 |
| 1235548108 | Tiffany Lee Ann Van Sickle | Case Manager/Care Coordinator | 198 E Center St., Moab, UT 84532 | 2014-08-05 |
| 1881991701 | Canyonlands Health Care Special Service District | Nursing Facility/Intermediate Care Facility | 390 W Williams Way, Moab, UT 84532 | 2011-02-14 |
| 1518267459 | Advance Medical Services, Inc | Durable Medical Equipment & Medical Supplies | 1105 South Highway Building 1, Moab, UT 84532 | 2010-10-26 |
| 1164694691 | Kenneth B Lindsay | Case Manager/Care Coordinator | 48 North Shields, Moab, UT 84532 | 2008-03-25 |
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| 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 |
|---|---|---|---|---|
| 1588978738 | San Juan County Hospital | Family Medicine | 11850 S Highway 191 Ste B10, Moab, UT 84532-3924 | 2010-07-29 |
| 1093804809 | Ray Allen Andrew | Family Medicine | 255 Williams Way, Moab, UT 84532-2370 | 2006-10-11 |
| 1023091931 | Kenneth Lewis Williams | Family Medicine | 476 Williams Way, Ste A, Moab, UT 84532-2065 | 2005-11-23 |
| 1295717759 | Donald Nilan Marquardt | Family Medicine | 267 N Main St, Moab, UT 84532-2342 | 2005-11-18 |
| 1063826832 | Paul Michael Johnson | Family Medicine | 450 Williams Way, Moab, UT 84532-2185 | 2014-06-19 |
| 1356636609 | Dylan Cole | Family Medicine | 476 Williams Way, Suite A, Moab, UT 84532-2065 | 2011-06-15 |
| 1457435513 | Patrick Mark Scherer | Family Medicine | 450 Williams Way, Moab, UT 84532-2185 | 2006-10-25 |
| 1902917438 | Nicole Lee Priest | Family Medicine | 476 Williams Way, Ste A, Moab, UT 84532-2065 | 2006-08-31 |
| 1528070489 | Moab Family Medicine PC | Family Medicine | 476 Williams Way, A, Moab, UT 84532-2065 | 2006-08-12 |
| 1669455580 | Katherine Kallmeyer Williams | Family Medicine | 476 Williams Way, Ste A, Moab, UT 84532-2065 | 2005-11-23 |
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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.