SCL HEALTH MEDICAL GROUP - GRAND JUNCTION, LLC (NPI# 1649883547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649883547 |
Entity Type | Organization |
Organization Name | SCL HEALTH MEDICAL GROUP - GRAND JUNCTION, LLC |
Practice Address |
450 Williams Way Moab UT 84532-2185 |
Practice Telephone | 4357193500 |
Practice Fax Number | 4357193529 |
Mailing Telephone | 4357193500 |
Mailing Fax Number | 4357193529 |
Enumeration Date | 2020-08-28 |
Last Update Date | 2020-08-28 |
Authorized Official Name | JON MCDANIEL (VP FINANCE MEDICAL GROUP) |
Authorized Official Telephone | 3032720231 |
Is Organization Subpart | Y |
Parent Organization Name | SCL HEALTH FRONT RANGE, INC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
SMMG Satellite - Medical Oncology Moab | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285248054 | Scl Health Medical Group - Grand Junction, LLC | Internal Medicine | 2635 N 7th St Ste 20, Grand Junction, CO 81501-8209 | 2020-08-31 |
1396358578 | Scl Health Medical Group - Grand Junction, LLC | Neurological Surgery | 350 Market St Unit 1, Basalt, CO 81621-7410 | 2020-08-26 |
1497368674 | Scl Health Medical Group - Grand Junction, LLC | Internal Medicine | 2643 Patterson Rd Ste 406, Grand Junction, CO 81506-1937 | 2020-08-26 |
1548873722 | Scl Health Medical Group - Grand Junction, LLC | Physical Medicine & Rehabilitation | 2686 Patterson Rd Unit 41, Grand Junction, CO 81506-8817 | 2020-08-26 |
1821695370 | Scl Health Medical Group - Grand Junction, LLC | Internal Medicine | 296 Stafford Ln, Delta, CO 81416-2243 | 2020-10-07 |
1174120125 | Scl Health Medical Group - Grand Junction, LLC | Family Medicine | 2503 Foresight Cir, Grand Junction, CO 81505-1139 | 2020-10-02 |
1730786971 | Scl Health Medical Group - Grand Junction, LLC | Surgery | 2635 N 7th St, Grand Junction, CO 81501-8209 | 2020-10-01 |
1043825516 | Scl Health Medical Group - Grand Junction, LLC | Internal Medicine | 401 Castle Creek Rd, Aspen, CO 81611-1159 | 2020-09-11 |
1437764222 | Scl Health Medical Group - Grand Junction, LLC | Pediatrics | 2635 N 7th St, Grand Junction, CO 81501-8209 | 2020-09-09 |
1417562216 | Scl Health Medical Group - Grand Junction, LLC | Surgery | 2635 N 7th St, Grand Junction, CO 81501-8209 | 2020-09-09 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Colorado Business Entities | SCL Health Medical Group - Grand Junction, LLC | 500 Eldorado Blvd Ste 4300, Attn Legal Services, Broomfield, CO 80021 |
Street Address |
450 WILLIAMS WAY |
City | MOAB |
State | UT |
Zip Code | 84532-2185 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700857398 | Moab Valley Healthcare Inc | Anesthesiology | 450 Williams Way, Moab, UT 84532 | 2006-01-31 |
1255810123 | Matthew Okelberry | Physical Therapist | 450 Williams Way, Moab, UT 84532-2185 | 2018-08-10 |
1104336528 | Paul Edward Kionka | Occupational Therapist | 450 Williams Way, Moab, UT 84532-2185 | 2017-10-11 |
1134672371 | Hannah Elizabeth Bodenhamer | Physician Assistant | 450 Williams Way, Moab, UT 84532-2185 | 2016-07-24 |
1063826832 | Paul Michael Johnson | Family Medicine | 450 Williams Way, Moab, UT 84532-2185 | 2014-06-19 |
1881012235 | Lauren Prest | Psychiatry & Neurology | 450 Williams Way, Moab, UT 84532-2185 | 2014-04-02 |
1023454683 | Kimberly Franke | Orthopaedic Surgery | 450 Williams Way, Moab, UT 84532-2185 | 2013-05-21 |
1316288814 | James Walling | Radiology Practitioner Assistant | 450 Williams Way, Moab, UT 84532-2065 | 2013-03-07 |
1578858171 | Michael A Kueber Jr. | Emergency Medicine | 450 Williams Way, Moab, UT 84532-2185 | 2011-06-13 |
1811289416 | Laird Ian Clark | Nurse Anesthetist, Certified Registered | 450 Williams Way, Moab, UT 84532-2185 | 2011-05-15 |
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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 | 207RH0003X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Hematology & Oncology |
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881123172 | Scott Marriner Browning | Internal Medicine | 2318 E Field Rose Dr, Salt Lake City, UT 84121-1500 | 2017-06-08 |
1356745137 | University of Utah Adult Services | Internal Medicine | 1950 E Circle of Hope Drive, Salt Lake City, UT 84112 | 2014-10-22 |
1982049227 | Bryan D Huber | Internal Medicine | 8th Avenue & C Street E8, Salt Lake City, UT 84143-3403 | 2013-04-30 |
1851631139 | Central Utah Clinic, P.C. | Internal Medicine | 2019 E Riverside Dr, Suite A200, St George, UT 84790-8134 | 2013-02-22 |
1285929430 | Brandt L Esplin | Internal Medicine | 1055 N 500 W Ste 202, Bldg C, Provo, UT 84604-8460 | 2011-06-16 |
1457664005 | Sabarinath Venniyil Radhakrishna | Internal Medicine | 2000 Circle of Hope, Suite 2100, Huntsman Cancer Institute, Salt Lake City, UT 84112 | 2010-07-23 |
1427273705 | Utah Hematology Oncology PC | Internal Medicine | 4403 Harrison Blvd Ste 1685, Ogden, UT 84403-3274 | 2007-04-13 |
1225164114 | Finn Bo Petersen | Internal Medicine | E8 Lds Hospital, 8th Avenue and C Street, Salt Lake City, UT 84143-0001 | 2007-02-26 |
1124172697 | Justin A Call | Internal Medicine | 3592 W 9000 S, Ste 200, West Jordan, UT 84088-8812 | 2007-01-22 |
1164524864 | Jay C Bott | Internal Medicine | 177 S 240 W, Orem, UT 84058-3052 | 2006-09-02 |
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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.