MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC. (NPI# 1710329958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710329958 |
| Entity Type | Organization |
| Organization Name | MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC. |
| Practice Address |
750 N 200 W Suite 201 Provo UT 84601-1677 |
| Practice Telephone | 8014292000 |
| Practice Fax Number | 8014292002 |
| Mailing Telephone | 8014292000 |
| Mailing Fax Number | 8014292002 |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2020-08-04 |
| Authorized Official Name | MR. TODD BAILEY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8014292000 |
| Authorized Official Credential | CMPE |
| Is Organization Subpart | Y |
| Parent Organization Name | MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | Pharmacy Service Providers | ||
| N | 183700000X | Pharmacy Technician | Pharmacy Service Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427437144 | Mountainlands Community Health Center, Inc. | Dentist | 299 E 900 S Ste 101, Provo, UT 84606-6107 | 2015-05-27 |
| 1154739787 | Mountainlands Community Health Center, Inc. | Clinic/Center | 133 S 500 E, Suite 101, Vernal, UT 84078-2728 | 2014-07-28 |
| Street Address |
750 N 200 W SUITE 201 |
| City | PROVO |
| State | UT |
| Zip Code | 84601-1677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205943180 | Darren James Gillespie | Social Worker | 750 N 200 W, Provo, UT 84601 | 2006-08-24 |
| 1447775945 | Victoria Elizabeth Rosa | Case Manager/Care Coordinator | 750 N 200 W, Provo, UT 84601 | 2017-08-07 |
| 1932623378 | Alisha Lynne Peart | Student in an Organized Health Care Education/Training Program | 750 N 200 W, Provo, UT 84601-1677 | 2017-07-27 |
| 1538681358 | Stephanie Ann Hundley | Social Worker | 750 N 200 W, Provo, UT 84601-1677 | 2017-07-13 |
| 1689196958 | Hanna Morgan | Peer Specialist | 750 N 200 W, Provo, UT 84601-1677 | 2017-07-08 |
| 1285188748 | Abish Shelem Lugo | Social Worker | 750 N 200 W, Provo, UT 84601-1677 | 2016-08-12 |
| 1558815654 | Lauren Mattinson | Case Manager/Care Coordinator | 750 N 200 W, Provo, UT 84601-1677 | 2016-08-08 |
| 1992155709 | Adarienn Marrott | Case Manager/Care Coordinator | 750 N 200 W, Provo, UT 84601-1677 | 2016-06-13 |
| 1841652625 | Kobie Chapman | Student in an Organized Health Care Education/Training Program | 750 N 200 W, Provo, UT 84601-1677 | 2016-03-22 |
| 1750749412 | Jarom Williams | Peer Specialist | 750 N 200 W, Provo, UT 84601-1677 | 2016-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902378417 | 1 Assist Care of Utah Valley LLC | In Home Supportive Care | 180 N University Avenue, Suite 270, Office 213, Provo, UT 84601 | 2018-12-21 |
| 1346723319 | Mp Dental LLC | Dentist | 777 N. 500 W. #204, Proud, UT 84601 | 2018-09-14 |
| 1326530601 | Madison Paige Nelson | Case Manager/Care Coordinator | 750 N Freedom Blvd., Provo, UT 84601 | 2018-06-03 |
| 1245758861 | Annette Roylance | Case Manager/Care Coordinator | 750 North Freedom Boulevard, Suite 300, Provo, UT 84601 | 2017-09-04 |
| 1912422205 | Alexandra Mcbride | Specialist/Technologist | 35 N 300 W #440, Provo, UT 84601 | 2017-08-07 |
| 1932638293 | Audrey Clara Clifton | Case Manager/Care Coordinator | 750 North Freedom Blvd., Provo, UT 84601 | 2017-06-08 |
| 1528514197 | Joseph Hyrum Lewis | Case Manager/Care Coordinator | 750 Freedom Blvd, Provo, UT 84601 | 2016-09-01 |
| 1629427620 | Walker Clements | Case Manager/Care Coordinator | 750 North Freedom Blvd, Provo, UT 84601 | 2016-06-09 |
| 1447611595 | Robert Shirley | Student in an Organized Health Care Education/Training Program | 750 North 200 West, Provo, Ut 84601., Provo, UT 84601 | 2016-03-17 |
| 1700286283 | Brelynn Downs | Student in an Organized Health Care Education/Training Program | 750 North Freedom Blvde, Provo, UT 84601 | 2014-09-03 |
| Find all providers in zip 84601 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453160 | Utah Valley Natural Health Clinic | Family Medicine | 3311 N University Ave Ste 100, Provo, UT 84604-7432 | 2020-10-06 |
| 1750840054 | Jonathon Lee Gross | Family Medicine | 395 W Cougar Blvd Ste 205, Provo, UT 84604-3328 | 2019-03-16 |
| 1275099897 | Optimal Health Family Practice Pllc | Family Medicine | 75 S 200 E Ste 100, Provo, UT 84606-3146 | 2019-02-19 |
| 1518414481 | Ihc Health Services Inc | Family Medicine | 395 W Bulldog Blvd Ste 603, Provo, UT 84604 | 2016-09-08 |
| 1790175628 | Brigham Young University | Family Medicine | 173 Richards Building, Dance Department, Provo, UT 84602-2000 | 2015-01-30 |
| 1790198141 | Micia Roby | Family Medicine | 1055 N 500 W Building A, Provo, UT 84604 | 2014-06-03 |
| 1295171874 | Angel Kae Lybbert | Family Medicine | 395 W. Bulldog Blvd. Suite 6b, Provo, UT 84604 | 2013-05-22 |
| 1912267212 | Ihc Health Services Inc | Family Medicine | 1401 E 2000 S, Provo, UT 84606-2072 | 2012-05-21 |
| 1710250253 | Mark Timothy Ross | Family Medicine | 3737 N 970 E, Provo, UT 84604-5247 | 2012-02-14 |
| 1639497191 | John Frederic Templeman | Family Medicine | 4728 Mile High Dr, Provo, UT 84604-5318 | 2010-05-08 |
| Find all providers in PROVO | ||||
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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.