MOUNTAIN VISTA MEDICINE (NPI# 1609123512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609123512 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN VISTA MEDICINE |
| Practice Address |
1258 W South Jordan Pkwy 103 South Jordan UT 84095 |
| Mailing Address |
1258 W South Jordan Pkwy 103 South Jordan UT 84095-4711 |
| Practice Telephone | 8018389090 |
| Practice Fax Number | 8018389092 |
| Mailing Telephone | 8018389090 |
| Mailing Fax Number | 8018389092 |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2018-07-02 |
| Authorized Official Name | MIKE T SWINYARD (OWNER) |
| Authorized Official Telephone | 8018389090 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
292580-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| INDIVDUAL NPI | 1245222819 | 01 |
| Street Address |
1258 W SOUTH JORDAN PKWY 103 |
| City | SOUTH JORDAN |
| State | UT |
| Zip Code | 84095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952329351 | John Ellis Boden | Counselor | 1258 W South Jordan Pkwy, Suite 202, South Jordan, UT 84095-4711 | 2006-07-17 |
| 1346788171 | Corey Christensen | Counselor | 1258 W South Jordan Pkwy, South Jordan, UT 84095-4711 | 2017-01-31 |
| 1912441288 | Taunya Cox | Counselor | 1258 W South Jordan Pkwy, Suite 202, South Jordan, UT 84095-4711 | 2016-12-06 |
| 1861942864 | Holly Pack Squires | Marriage & Family Therapist | 1258 W South Jordan Pkwy, Suite 202, South Jordan, UT 84095-4711 | 2016-10-13 |
| 1780035501 | Carole Mounteer Kamradt | Counselor | 1258 W South Jordan Pkwy, Suite 202, South Jordan, UT 84095-4711 | 2016-06-22 |
| 1396148896 | Lynda R Healey | Nurse Practitioner | 1258 W South Jordan Pkwy, South Jordan, UT 84095-4711 | 2014-09-29 |
| 1245672641 | Julie Holbrook | Marriage & Family Therapist | 1258 W South Jordan Pkwy, South Jordan, UT 84095-4711 | 2013-07-25 |
| 1730420696 | Darin Terry Hansen | Social Worker | 1258 W South Jordan Pkwy, South Jordan, UT 84095-4711 | 2013-03-01 |
| 1144569112 | Shay Clark | Counselor | 1258 W South Jordan Pkwy, South Jordan, UT 84095-4711 | 2013-02-11 |
| 1710226956 | Suncrest Counseling | Counselor | 1258 W South Jordan Pkwy, South Jordan, UT 84095-4711 | 2013-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033745393 | Beverly Laraine Williams | Social Worker | 11260 S River Heights Drive, South Jordan, UT 84095 | 2020-03-19 |
| 1265902902 | Sarah Richele Kelley | Specialist/Technologist | 10236 Alder Grovey Way, South Jordan, UT 84095 | 2018-11-26 |
| 1326528837 | Kristi Couse | Massage Therapist | 10679 S 2200 W Apt 2, South Jordan, UT 84095 | 2018-08-15 |
| 1821516063 | River Crossing Dental Professional Corporation | Clinic/Center | 12427 South 4000 West, Suite #200, Riverton, UT 84095 | 2017-09-08 |
| 1245755719 | Staci Stout | Dental Hygienist | 3113 W Swiss Pass Cir, South Jordan, UT 84095 | 2017-08-07 |
| 1437698750 | Ryan Sears | Dentist | 10894 So. River Front Parkway, South Jordan, UT 84095 | 2017-02-20 |
| 1366989931 | Ultimate Sports Regenerative Medicine | Chiropractor | 1098 W. South Jordan Pkwy, Suite 101, South Jordan, UT 84095 | 2017-01-20 |
| 1306393889 | Tal Quirl | Optometrist | 3571 W. 10400 S., South Jordan, UT 84095 | 2016-09-01 |
| 1023562667 | Sevon Taroian | Social Worker | 11260 River Heights Drive, South Jordan, UT 84095 | 2016-08-11 |
| 1952762932 | Megan Buckley | Developmental Therapist | 881 Baxter Drive, Ste 100, South Jordan, UT 84095 | 2016-03-17 |
| Find all providers in zip 84095 | ||||
| Taxonomy Code | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245222819 | Michael T. Swinyard | Pediatrics | 1258 W South Jordan Pkwy Ste 103, South Jordan, UT 84095-4712 | 2005-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568826048 | University of Utah Pediatric Services | Pediatrics | 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 | 2016-04-11 |
| 1962760033 | Kathleen Halley Timme | Pediatrics | 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 | 2012-04-26 |
| 1326364175 | Allison Rose Smego | Pediatrics | 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 | 2010-04-19 |
| 1023244530 | Mark Edward Hamaker | Pediatrics | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2009-06-10 |
| 1649478512 | Scott Andrew Clements | Pediatrics | 81 N Mario Capecchi Dr, Eccles Outpatient Building, Salt Lake City, UT 84113-1125 | 2007-07-03 |
| 1538281050 | Alan N Lindsay | Pediatrics | 508 E South Temple, Suite 310, Salt Lake City, UT 84102-1013 | 2007-04-04 |
| 1871672345 | Carol M. Foster | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2006-11-03 |
| City | SOUTH JORDAN |
| Zip Code | 84095 |
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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.