VICTOR CLARK (NPI# 1649687948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649687948 |
| Entity Type | Individual |
| Full Name | VICTOR CLARK |
| Practice Address |
6352 W 13100 S Herriman UT 84096 |
| Practice Telephone | 8019031040 |
| Practice Fax Number | 8014466293 |
| Mailing Telephone | 8019031040 |
| Mailing Fax Number | 8014466293 |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2014-07-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 2014-ALIIUT00065 | UT | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669551727 | Victor Gerard Clark | Counselor | 330 Barnard Ave Ste 2, Asheville, NC 28804-3275 | 2006-11-02 |
| 1821251943 | Victor Pierre Clark | Internal Medicine | 825 Fairfax Ave, Suite 445, Norfolk, VA 23507-1914 | 2008-07-09 |
| 1578641429 | Victor Lee Clark | Dentist | 733 Oakwood Dr, Fenton, MO 63026-3535 | 2006-11-01 |
| Street Address |
6352 W 13100 S |
| City | HERRIMAN |
| State | UT |
| Zip Code | 84096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417340696 | Apiary Management Group | Assisted Living Facility | 6352 W 13100 S, Herriman, UT 84096-3872 | 2015-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306499249 | Abundant Dental Care, P.C. | Dentist | 5089 West 12600 South, Herriman, UT 84096 | 2019-07-19 |
| 1225563703 | Kristen Haslam | Specialist/Technologist, Other | 13947 S Newburg Dr., Herriman, UT 84096 | 2017-04-21 |
| 1770960452 | Tyler Rolland Petersen | Social Worker | 13351 S Shaunna Lane, Herriman, UT 84096 | 2015-05-01 |
| 1548539554 | Neck and Back Relief | Chiropractor | 12600 S. 4013 W., Suite E, Riverton, UT 84096 | 2011-12-20 |
| 1114220092 | Sharlene Christensen | Counselor | 13878 S. Ken Cv, Herriman, UT 84096 | 2010-12-14 |
| 1518156991 | Jon Christian Fairbanks | Dentist | 5532 W. Herriman Main Street, #210, Herriman, UT 84096 | 2007-10-22 |
| 1215154232 | Karen Jane Olson | Nurse Practitioner | 13400 S. 5746 W #200, Herriman, UT 84096 | 2007-04-19 |
| 1619022969 | Jeffrey T Lambert | Dentist | 5532 W. Herriman Main St., #210, Herriman, UT 84096 | 2007-01-25 |
| 1578638854 | Stevenson Pediatric Dentistry P.C. | Dentist | 4019 W. 12600 S., Suite 200, Riverton, UT 84096 | 2006-11-21 |
| 1730278946 | Rebecca Mostatab | Dentist | 4531 W Partridgehill Lane, Suite F-110, Riverton, UT 84096 | 2006-10-12 |
| Find all providers in zip 84096 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417340696 | Apiary Management Group | Assisted Living Facility | 6352 W 13100 S, Herriman, UT 84096-3872 | 2015-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689273468 | Joel C. Horne & Co., Inc. | Assisted Living Facility | 831 S 700 W Bldg B, Hurricane, UT 84737-2502 | 2020-10-22 |
| 1578160321 | Golden Horizons, LLC | Assisted Living Facility | 535 N 600 W, Richfield, UT 84701-1767 | 2020-10-05 |
| 1144835117 | Sre Asl Lindon, LLC | Assisted Living Facility | 815 W 700 N, Lindon, UT 84042-1446 | 2020-09-15 |
| 1407461460 | Sre Asl Sg, LLC | Assisted Living Facility | 2654 Red Cliffs Dr, St George, UT 84790-5827 | 2020-09-15 |
| 1992319073 | Rocky Mountain Care - Vernal Manager, LLC | Assisted Living Facility | 301 E 100 S, Vernal, UT 84078-2633 | 2020-09-04 |
| 1558988923 | Rocky Mountain Care - Lindon Manager, LLC | Assisted Living Facility | 175 N State St, Lindon, UT 84042-1813 | 2020-07-01 |
| 1689294696 | Inception Holdings | Assisted Living Facility | 3306 W 3800 S, West Valley, UT 84119-4431 | 2020-04-20 |
| 1841828803 | Mg Cottonwood Heights Subtenant LLC | Assisted Living Facility | 7235 S Union Park Ave, Cottonwood Heights, UT 84047-4700 | 2020-03-27 |
| 1558993337 | Holladay Home Assisted Living LLC | Assisted Living Facility | 5950 S Highland Dr, Holladay, UT 84121-1328 | 2020-02-10 |
| 1740811223 | A Level Ventures | Assisted Living Facility | 940 N 2335 W, Vernal, UT 84078-8300 | 2020-02-03 |
| Find all providers with the same taxonomy | ||||
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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.