ARMANDO WAYNE SLACK (NPI# 1659572949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659572949 |
| Entity Type | Individual |
| Full Name | ARMANDO WAYNE SLACK |
| Other Name | MANNY WAYNE SLACK |
| Credential | R.N. |
| Practice Address |
190 S Main St Centerville UT 84014 |
| Mailing Address |
190 S Main St Centerville UT 84014-2832 |
| Practice Telephone | 8016148400 |
| Mailing Telephone | 8016148400 |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2019-03-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WA0400X |
Registered Nurse Specialization: Addiction (Substance Use Disorder) |
2943543102 | UT | Nursing Service Providers |
| N | 163WX0200X |
Registered Nurse Specialization: Oncology |
2943543102 | UT | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
2943544405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2788 Edgehill Dr, Bountiful, UT 840104332 | 8015574257 | 8012957779 |
| Street Address |
190 S MAIN ST |
| City | CENTERVILLE |
| State | UT |
| Zip Code | 84014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659753937 | Brandon Segura | Psychologist | 190 S Main St, Ste 400, Centerville, UT 84014-2814 | 2015-06-23 |
| 1053712034 | Crossroads Counseling, Pllc | Counselor | 190 S Main St, Ste 100, Centerville, UT 84014-2814 | 2014-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346879160 | Nanette F Reid | Physical Therapist | 103 West 1450 North, Centerville, UT 84014 | 2020-04-03 |
| 1124557541 | Julie Blundell | Social Worker | 1634 Lewis and Clark Dr, Centerville, UT 84014 | 2017-06-08 |
| 1588843395 | Lorant Steve Bodo | Assisted Living Facility | 463 West Rawlins Circle, Centerville, UT 84014 | 2007-10-29 |
| 1467588004 | Pitt Family Dental | Dentist | 281 South Main, Centerville, UT 84014 | 2007-02-26 |
| 1841346467 | Lds Family Services | Specialist | 94a East Pages Lane, Centerville, UT 84014 | 2007-01-26 |
| 1275690489 | Do-it for You | Chore Provider | 291 E Casa Loma Drive, Centerville, UT 84014 | 2007-01-03 |
| 1558455527 | Brian D Rigby | Dentist | 44 East 100 South, Suite 100, Centerville, UT 84014 | 2006-10-03 |
| 1588756407 | Gary A Lawson | Dentist | 1080 South 400 East, Centerville, UT 84014 | 2006-09-28 |
| 1811526353 | Reid Physical Therapy | Physical Therapist | 103 West 1450 North, Centerville, UT 84014 | 2020-04-06 |
| 1669683728 | David M. Huffaker | Dentist | 134 South Main, Centerville, UT 84014 | 2007-05-24 |
| Find all providers in zip 84014 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821703 | Paula S. Gordy Lisw, LLC | Nurse Practitioner | 501 N 12th St Ste 1, Centerville, IA 52544-1439 | 2020-11-02 |
| 1912511288 | Emily Wilcox | Nurse Practitioner | 190 S Main St Ste B, Centerville, UT 84014-2839 | 2020-09-03 |
| 1871126482 | Loretta Pentlicki | Nurse Practitioner | 150 E Swan St, Centerville, TN 37033-1446 | 2020-02-21 |
| 1730733189 | Christine A Wilcox | Nurse Practitioner | 1185 Falmouth Rd, Centerville, MA 02632-3066 | 2019-07-24 |
| 1265094304 | Krista Lynn Johnson | Nurse Practitioner | 221 E State St, Centerville, IA 52544-1813 | 2019-06-28 |
| 1770953291 | Toni Peters | Nurse Practitioner | 7901 Schatz Pointe Dr, Suite A, Centerville, OH 45459-3856 | 2015-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114536737 | Bradley Martin | Nurse Practitioner | 31 M St Apt 110, Salt Lake City, UT 84103-3846 | 2020-07-29 |
| 1710595178 | Shannon Lee Zaryoun | Nurse Practitioner | 7970 S Grand Vista Way, Cottonwood Heights, UT 84121-5683 | 2020-07-21 |
| 1023640851 | Senior Nurse Practitioner Consultants | Nurse Practitioner | 5802 S 900 E # 3, Murray, UT 84121-1644 | 2020-02-10 |
| 1245877448 | Carla Lucile Applegate-anderson | Nurse Practitioner | 2666 South 2000 East, Suite 101, Salt Lake City, UT 84109 | 2019-12-06 |
| 1124676044 | Marie R. Hurst | Nurse Practitioner | 5974 Fashion Point Dr Ste 140, South Ogden, UT 84403-4838 | 2019-09-04 |
| 1437706058 | Austin Sumner Heaps | Nurse Practitioner | 1044 N 600 E, Morgan, UT 84050-9269 | 2019-08-19 |
| 1821565839 | Clint Lee Martineau | Nurse Practitioner | 230 N 1680 E # 1, Saint George, UT 84790-2579 | 2018-10-28 |
| 1356827505 | Ashley Smith | Nurse Practitioner | 515 N 600 E, Hyrum, UT 84319-1133 | 2018-07-11 |
| 1588176606 | Bradley Keep | Nurse Practitioner | 4610 W 9980 N, Cedar Hills, UT 84062-8728 | 2017-10-30 |
| 1023548070 | Sarah Leggett | Nurse Practitioner | 9235 S Redwood Rd Ste A, West Jordan, UT 84088-5811 | 2017-06-13 |
| Find all providers with the same taxonomy | ||||
| City | CENTERVILLE |
| Zip Code | 84014 |
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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.