KELLY W MAUGHAN (NPI# 1629396882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629396882 |
| Entity Type | Individual |
| Full Name | KELLY W MAUGHAN |
| Credential | RPH |
| Practice Address |
2400 N Washington Blvd North Ogden UT 84414-7233 |
| Practice Telephone | 8017867600 |
| Practice Fax Number | 8017867610 |
| Mailing Telephone | 8017867600 |
| Mailing Fax Number | 8017867610 |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2010-05-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 286410-1701 | UT | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | DOPL PHARMACIST CONTROLLED SUBSTANCE | 286410-8911 | 01 |
| UT | DOPL PHARMACIST | 286410-1701 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225258239 | Kelly Ann Maughan | Physical Therapy Assistant | 5979 Vineland Rd, 304, Orlando, FL 32819-7800 | 2007-05-01 |
| Street Address |
2400 N WASHINGTON BLVD |
| City | NORTH OGDEN |
| State | UT |
| Zip Code | 84414-7233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033676218 | Patricia Grissom | Nurse Practitioner | 2400 N Washington Blvd, North Ogden, UT 84414-7233 | 2019-02-25 |
| 1235574583 | Jean Mcguire | Family Medicine | 2400 N Washington Blvd, North Ogden, UT 84414-7233 | 2013-04-30 |
| 1467753798 | Nicole Rae Summers | Family Medicine | 2400 N Washington Blvd, North Ogden, UT 84414-7233 | 2010-11-03 |
| 1710298708 | Marc Michael Wangsgard | Family Medicine | 2400 N Washington Blvd, North Ogden, UT 84414-7233 | 2010-06-24 |
| 1043539844 | Trent P Florence | Pharmacist | 2400 N Washington Blvd, North Ogden, UT 84414-7233 | 2010-05-19 |
| 1619175189 | Benjamin Barraclough | Family Medicine | 2400 N Washington Blvd, North Ogden, UT 84414-7233 | 2007-07-06 |
| 1982816351 | Philip Jiricko | Preventive Medicine | 2400 N Washington Blvd, North Ogden, UT 84414-7233 | 2007-05-05 |
| 1033240460 | Ihc Health Services Inc | Emergency Medicine | 2400 N Washington Blvd, North Ogden, UT 84414-7233 | 2007-03-08 |
| 1770658684 | Daniel Dennis Alsup Jr. | Family Medicine | 2400 N Washington Blvd, North Ogden, UT 84414-7233 | 2006-11-24 |
| 1053481986 | Lee Carl Schussman | Family Medicine | 2400 N Washington Blvd, North Ogden, UT 84414-7233 | 2006-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881986305 | Abigail Lauren Jenkins | Psychologist | 3836 N 700 E, Ogden, UT 84414 | 2011-05-03 |
| 1003145947 | Lomond View Dental | Dentist | 2685 North 1000 West, Suite 101, Pleasant View, UT 84414 | 2009-12-23 |
| 1609058528 | Pleasant View Dialysis | Clinic/Center | 2715 N Hwy 89, Pleasant View, UT 84414 | 2007-12-03 |
| 1902934243 | Jlsco LLC | Pharmacy | 2645 N Washington Blvd, North Ogden, UT 84414 | 2007-02-28 |
| 1700930716 | Choice Supported Employment Services Inc | Day Training, Developmentally Disabled Services | 3942 N 650 W, Community Based Services To Help Find Employment Commun, Pleasant View, UT 84414 | 2007-01-23 |
| 1891873055 | Michael Stephen Affleck | Dentist | 2537 N 400e, North Ogden, UT 84414 | 2006-11-02 |
| 1659453421 | Michael Dale Swenson | Dentist | 2252 N 400 E, North Ogden, UT 84414 | 2006-10-20 |
| 1477662187 | Paul D Hopkins Dds PC | Dentist | 859 W Pleasant View Dr, Pleasant View, UT 84414 | 2006-08-29 |
| 1801812714 | Brendan Rodney Green | Dentist | 2707 North 400 East, North Ogden, UT 84414 | 2006-07-14 |
| 1669419701 | Mark E Harris | Dentist | 2274 N 400 E, Suite 204, North Ogden, UT 84414 | 2006-05-31 |
| Find all providers in zip 84414 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821639170 | Trace R Hellstrom | Pharmacist | 2343 N 400 E, North Ogden, UT 84414-7232 | 2019-10-07 |
| 1093922262 | Ronald Bert Malouf | Pharmacist | 2835 N 975 E, North Ogden, UT 84414-2423 | 2007-05-17 |
| 1407497761 | Jared D Crowther | Pharmacist | 2434 N 400 E, North Ogden, UT 84414-7233 | 2019-10-07 |
| 1144502048 | Mike T Mathis | Pharmacist | 2555 N 400 E, North Ogden, UT 84414-7217 | 2011-09-15 |
| 1447531199 | Amanda Anne Jensen | Pharmacist | 2555 N 400 E, North Ogden, UT 84414-7217 | 2011-09-07 |
| 1487934758 | Dale Brown | Pharmacist | 1100 W 2700 N, North Ogden, UT 84404-4791 | 2011-08-18 |
| 1043539844 | Trent P Florence | Pharmacist | 2400 N Washington Blvd, North Ogden, UT 84414-7233 | 2010-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457952459 | Deanna Rae Moultrie | Pharmacist | 1268 N 225 W, Centerville, UT 84014-1104 | 2020-11-05 |
| 1659972248 | William Lance Andersen | Pharmacist | 1202 W 12600 W, Riverton, UT 84065 | 2020-11-02 |
| 1487255907 | Todd Shakespeare | Pharmacist | 1330 S Providence, Cedar City, UT 84720 | 2020-11-02 |
| 1245830108 | Chadwick M Smith | Pharmacist | 7494 S 2135 E, Salt Lake City, UT 84121-4970 | 2020-10-29 |
| 1356940209 | Melody Mercedes Padilla | Pharmacist | 325 S Orchard Dr Apt C106, North Salt Lake, UT 84054-1861 | 2020-10-21 |
| 1457965824 | Duy Danny Vo | Pharmacist | 7200 S State St, Midvale, UT 84047 | 2020-09-03 |
| 1568075463 | Brent West | Pharmacist | 19 W Clover Ln, Washington, UT 84780-8208 | 2020-08-28 |
| 1568074318 | Kelli Thorup | Pharmacist | 458 E Emerson Ave, Salt Lake City, UT 84115-1531 | 2020-08-21 |
| 1861003865 | Devin S Jackson | Pharmacist | 1311 E Draper Pkwy, Draper, UT 84020-8567 | 2020-08-12 |
| 1376154435 | James Lindsay Clark | Pharmacist | 201 S 1300 E Ste 101, Salt Lake City, UT 84102-2608 | 2020-08-12 |
| Find all providers with the same taxonomy | ||||
| City | NORTH OGDEN |
| Zip Code | 84414 |
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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.