ALISSA ANN PACKER (NPI# 1669647566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669647566 |
| Entity Type | Individual |
| Full Name | ALISSA ANN PACKER |
| Credential | M.D. |
| Practice Address |
9071 S 1300 W #301 West Jordan UT 84088-6672 |
| Practice Telephone | 8015651162 |
| Practice Fax Number | 8015651168 |
| Mailing Telephone | 8015651162 |
| Mailing Fax Number | 8015651168 |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2013-07-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 6353362-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
9071 S 1300 W #301 |
| City | WEST JORDAN |
| State | UT |
| Zip Code | 84088-6672 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225010051 | Darin G Bosworth | Pediatrics | 9071 S 1300 W, #301, West Jordan, UT 84088-6672 | 2005-11-17 |
| 1457760803 | Mary Thomas | Pediatrics | 9071 S 1300 W, Suite 301, West Jordan, UT 84088-6672 | 2014-08-11 |
| 1417219080 | Christopher Andrew Cook | Nurse Practitioner | 9071 S 1300 W, #301, West Jordan, UT 84088-6672 | 2012-06-11 |
| 1124301965 | Austin Jack Singleton | Audiologist | 9071 S 1300 W, Ste 100, West Jordan, UT 84088-6672 | 2011-09-27 |
| 1386807790 | Teresa Prince Mcnaught | Nurse Practitioner | 9071 S 1300 W, Suite 301, West Jordan, UT 84088-6672 | 2008-07-07 |
| 1184606782 | Leslie L Goodwin | Pediatrics | 9071 S 1300 W, #301, West Jordan, UT 84088-6672 | 2005-11-18 |
| 1013999630 | Kevin B Lash | Pediatrics | 9071 S 1300 W, #301, West Jordan, UT 84088-6672 | 2005-11-18 |
| 1952383796 | Brian J Buchanan | Pediatrics | 9071 S 1300 W, #301, West Jordan, UT 84088-6672 | 2005-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881178655 | Sierra Burt | Physician Assistant | 3584 West 90000 South Suite 304, West Jordan, UT 84088 | 2018-09-18 |
| 1659861847 | Miller Anesthesia Consultants PC | Anesthesiology | Jvmc Dept. of Anesthesiology, 3580 W. 9000 S., West Jordan, UT 84088 | 2018-05-14 |
| 1821501495 | Cleo Stephanides Cheney | Dentist | 8846 South Redwood Rd., Suite N201, West Jordan, UT 84088 | 2017-11-06 |
| 1124546742 | Crystal Lynn Santos | Counselor | 4431 8200 S, West Jordan, UT 84088 | 2017-09-04 |
| 1154705960 | Heston Farnsworth | Dentist | 9217 South Redwood Road, Suite B, West Jordan, UT 84088 | 2015-07-13 |
| 1750778767 | Andrew Cantwell | Dentist | 3855 7800 South #150, West Jordan, UT 84088 | 2015-04-17 |
| 1962764282 | Steven Howard Reano | Specialist | 8789 S Redwood Road, Ste 100, West Jordan, UT 84088 | 2012-06-12 |
| 1528328846 | Orthodontic Payment Services, LLC | Dentist | 1231 W 9000 S #d, West Jordan, UT 84088 | 2012-05-21 |
| 1588932321 | Jessica Millard | Counselor | 9278 S 1700 W, West Jordan, UT 84088 | 2011-12-08 |
| 1346553062 | Barbara Rouse | Counselor | 9278 Redwood Rd, West Jordan, UT 84088 | 2010-07-22 |
| Find all providers in zip 84088 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124548805 | Joshua Brent Maxwell | Pediatrics | 8822 S Redwood Rd Ste C211, West Jordan, UT 84088-9340 | 2017-06-22 |
| 1922163534 | Robert S Terashima | Pediatrics | 8925 South 2700 West, West Jordan, UT 84088 | 2006-12-26 |
| 1548206873 | John Tucker Davis | Pediatrics | Jordan Valley Pediatrics, 1561 West 7000 South, Suite 202, West Jordan, UT 84084 | 2006-06-22 |
| 1588620413 | Tazeem A Aizad | Pediatrics | 1561 W 7000 S, Ste # 202, West Jordan, UT 84084-3556 | 2006-04-20 |
| 1225010051 | Darin G Bosworth | Pediatrics | 9071 S 1300 W, #301, West Jordan, UT 84088-6672 | 2005-11-17 |
| 1457760803 | Mary Thomas | Pediatrics | 9071 S 1300 W, Suite 301, West Jordan, UT 84088-6672 | 2014-08-11 |
| 1568806941 | Adam Mickael Hutchinson | Pediatrics | 2655 W 9000 S, West Jordan, UT 84088-8542 | 2013-04-29 |
| 1801186838 | Molly Montes | Pediatrics | 8822 S Redwood Rd, Ste C211, West Jordan, UT 84088-9336 | 2011-04-11 |
| 1033421722 | Joseph L Kingston | Pediatrics | 6933 S 1300 W, West Jordan, UT 84084-2554 | 2010-07-09 |
| 1780905083 | James B Davis | Pediatrics | 2655 W 9000 S, West Jordan, UT 84088-8542 | 2010-06-21 |
| Find all providers in WEST JORDAN | ||||
| City | WEST JORDAN |
| Zip Code | 84088 |
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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.