VIBRANT HEALTH PC (NPI# 1659720936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659720936 |
| Entity Type | Organization |
| Organization Name | VIBRANT HEALTH PC |
| Practice Address |
1910 Prospector Ave Suite 302 Park City UT 84060 |
| Mailing Address |
12202 Deer Mountain Blvd Kamas UT 84036 |
| Practice Telephone | 4356040594 |
| Practice Fax Number | 8479198661 |
| Mailing Telephone | (435) 604-0594 |
| Mailing Fax Number | 8479198661 |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2017-08-25 |
| Authorized Official Name | DR. FATIMA VILICH (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4357829384 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 036097212 | IL | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | 10369621-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
1910 PROSPECTOR AVE SUITE 302 |
| City | PARK CITY |
| State | UT |
| Zip Code | 84060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982233920 | Livecare, Inc. | Nursing Care | 1830 Prospector Avenue, Park City, UT 84060 | 2020-04-02 |
| 1063904266 | Louise Knetzger Gallagher | Acupuncturist | 1107 Woodside Ave, Park City, UT 84060 | 2018-06-04 |
| 1942753421 | Valerie Alison Mey | Dietitian, Registered | 2985 Arabian Dr, Park City, UT 84060 | 2016-08-01 |
| 1538538657 | Pamela Hilbert | Dentist | 1830 Prospector Ave., Park City, UT 84060 | 2015-09-18 |
| 1174904924 | Julie Anna Bullen | Counselor | 2300 Monitor Drive, Park City, UT 84060 | 2015-06-17 |
| 1265825319 | William Gary Smith | Obstetrics & Gynecology | 2501 Creek Drive, Park City, UT 84060 | 2015-03-13 |
| 1497026330 | Earl Warren Stadler Jr. | Physical Medicine & Rehabilitation | 1500 Three Kings Drive Unit 31, Park City, UT 84060 | 2012-01-24 |
| 1538454541 | Belinda Duncan | Pharmacist | 2700 E Deer Valley Dr B105, Park City, UT 84060 | 2011-06-17 |
| 1184888315 | Cody Michael Calderwood | Dentist | 1600 Snow Creek Dr Ste A, Park City, UT 84060 | 2008-07-16 |
| 1306006671 | Bradford Lester | Acupuncturist | 50 Shadow Ridge Rd, Park City, UT 84060 | 2008-06-11 |
| Find all providers in zip 84060 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528352721 | Michael Aaron Kagen | Internal Medicine | 4580 Silver Springs Dr Ste 150, Park City, UT 84098-6198 | 2011-06-06 |
| 1942441068 | Robert Eugene Pellegrine | Internal Medicine | 2009 Mahre Dr, Park City, UT 84098-8510 | 2009-03-19 |
| 1437314291 | Jeffrey S Holverson | Internal Medicine | 6240 N Snowview Dr, Park City, UT 84098 | 2008-07-22 |
| 1578675708 | Sheila Varghese Maliekel | Internal Medicine | 401 Greenleaf St, Suite One, Park City, IL 60085-5744 | 2006-09-01 |
| 1497712376 | Kim Ellen Scott | Internal Medicine | 1777 Sun Peak Dr, Suite 150, Park City, UT 84098-6725 | 2006-04-26 |
| 1407812613 | Kim Scott Md Plc | Internal Medicine | 1790 Sun Peak Dr, Suite A101, Park City, UT 84098-6559 | 2006-04-25 |
| 1881661148 | Yusuf Qamar | Internal Medicine | 1755 E 61st St. N., Park City, KS 67219-1917 | 2006-03-07 |
| 1164063277 | Stat-md I | Internal Medicine | 1784 Uinta Way Unit E2, Park City, UT 84098-7685 | 2019-10-01 |
| 1104346543 | Jupiter Medical I LLC | Internal Medicine | 1784 Uinta Way Unit E2, Park City, UT 84098-7685 | 2017-06-27 |
| 1306394929 | Ihc Health Services Inc | Internal Medicine | 1493 Lowell Ave, Park City, UT 84060-5116 | 2016-09-12 |
| Find all providers in PARK CITY | ||||
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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.