INTERVENTIONAL SPINE & PAIN MANAGEMENT (NPI# 1609204338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609204338 |
Entity Type | Organization |
Organization Name | INTERVENTIONAL SPINE & PAIN MANAGEMENT |
Practice Address |
5801 S Fashion Blvd Ste 180 Murray UT 84107-8135 |
Mailing Address |
274 N Main St Logan UT 84321-3915 |
Practice Telephone | 8012627246 |
Mailing Telephone | 4357531600 |
Mailing Fax Number | 4357539521 |
Enumeration Date | 2013-10-15 |
Last Update Date | 2019-11-21 |
Authorized Official Name | DR. VIKAS GARG (OWNER) |
Authorized Official Telephone | 8012627246 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
1276 Wall Ave Ste 2, Ogden, UT 844045673 | 8012627246 | |
13953 S Bangerter Pkwy, Draper, UT 840205429 | 8012627246 | |
2380 N 400 E Ste A, North Logan, UT 843411756 | 4357139681 | 4357531201 |
346 E State Rd, Pleasant Grove, UT 840623617 | 8012627246 | |
900 Round Valley Dr Ste 120, Park City, UT 840607552 | 8012627246 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992342414 | Interventional Spine & Pain Management | Pain Medicine | 1276 Wall Ave Ste 2, Ogden, UT 84404-5673 | 2019-12-03 |
Street Address |
5801 S FASHION BLVD STE 180 |
City | MURRAY |
State | UT |
Zip Code | 84107-8135 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568942480 | Ivonne A Rodriguez | Physician Assistant | 5801 S Fashion Blvd Ste 180, Murray, UT 84107-8135 | 2018-08-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
Find all providers in zip 84107 |
Taxonomy Code | 207LP2900X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Anesthesiology |
Specialization | Pain Medicine |
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952865412 | Avail Medical LLC | Anesthesiology | 5742 S 1475 E Ste 200, South Ogden, UT 84403-4856 | 2019-01-29 |
1033597257 | Ashley Renee Donaldson | Anesthesiology | Spinal Interventions, 280 W River Park Drive Suite 200, Provo, UT 84604 | 2015-05-07 |
1225387491 | Clinton D. Olsen | Anesthesiology | 280 W River Park Dr, Suite 200, Provo, UT 84604-5793 | 2012-09-04 |
1134429384 | Intermountain Medical Monitoring LLC | Anesthesiology | 1306 Deer Crest, Fruit Heights, UT 84037 | 2010-10-21 |
1861622219 | Jeremy Joyal | Anesthesiology | 11760 S 700 E Ste 112, Draper, UT 84020-6605 | 2009-07-20 |
1205058294 | Joseph Courtney Empey | Anesthesiology | 617 E Riverside Dr Ste 301, St George, UT 84790-8722 | 2007-05-02 |
1962439570 | Gordon Petty George, Md, PC | Anesthesiology | 800 N 700 W, Ste 340a, Orem, UT 84057 | 2006-06-27 |
1770558090 | Bryan C Hoelzer | Anesthesiology | 320 River Park Dr Ste 255, Provo, UT 84604 | 2006-02-21 |
1164421053 | Dale Gerald Stott | Anesthesiology | 301 N 200 E, Suite 2a, St George, UT 84770-3010 | 2005-07-21 |
1437627080 | Advanced Spine and Pain Pllc | Anesthesiology | 11760 S 700 E Ste 112, Draper, UT 84020-6605 | 2018-11-12 |
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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.