NORTHEASTERN UTAH MEDICAL GROUP (NPI# 1740482009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740482009 |
| Entity Type | Organization |
| Organization Name | NORTHEASTERN UTAH MEDICAL GROUP |
| Practice Address |
210 W 300 N 75 3 Roosevelt UT 84066 |
| Practice Telephone | 4357223971 |
| Practice Fax Number | 4357226104 |
| Mailing Telephone | 4357223971 |
| Mailing Fax Number | 4357226104 |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2009-05-18 |
| Authorized Official Name | MR. ROGER K MARETT (CLINIC ADMINISTRATOR) |
| Authorized Official Telephone | 4357226270 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982664199 | Northeastern Utah Medical Group | Dermatology | 210 W 300 N 7-3, Roosevelt, UT 84066 | 2006-03-23 |
| 1316316482 | Northeastern Utah Medical Group | Physician Assistant | 250 W 300 N, Roosevelt, UT 84066-2336 | 2015-09-18 |
| Street Address |
210 W 300 N 75 3 |
| City | ROOSEVELT |
| State | UT |
| Zip Code | 84066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477075315 | Annemarie Rousseau | Registered Nurse | 250 West 300 North, Roosevelt, UT 84066 | 2017-07-12 |
| 1780036772 | Drew Gilley | Dentist | 375 E Lagoon St, Roosevelt, Ut 84066, Roosevelt, UT 84066 | 2016-07-01 |
| 1952758039 | Amanda Adams | Massage Therapist | 1151 East Hwy 40, Ballard, UT 84066 | 2016-05-19 |
| 1447624325 | Gregory George Page | Dentist | 209 West 200 North 71-2, Roosevelt, UT 84066 | 2015-11-16 |
| 1659785772 | Becky Ann Birch | Nurse Practitioner | 200 West 350 North, Ste 103, Roosevelt, UT 84066 | 2014-06-17 |
| 1760724280 | Novo Ranch LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3549 W 1000 North, Roosevelt, UT 84066 | 2013-03-22 |
| 1508110040 | Uintah Basin Spine and Disc Center, PC | Rehabilitation Unit | 1151 East Highway 40, Roosevelt, UT 84066 | 2012-11-06 |
| 1184918682 | Alvaro Beltran | Dentist | Ave. Lopez Mateos 171-4, Nogales, SONORA 84066 | 2011-06-02 |
| 1255638367 | Cosme Cantu | Dentist | Blvd. El Greco #45 Int. J-14, Nogales, SONORA 84066 | 2011-02-25 |
| 1851436471 | Dan Ray Robinson | Dentist | 675 South Rodeo Drive, Roosevelt, UT 84066 | 2007-02-21 |
| Find all providers in zip 84066 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427510163 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 380 Nassau Rd Ste P, Roosevelt, NY 11575-1343 | 2019-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285205 | Utah Diabetic Supply | Durable Medical Equipment & Medical Supplies | 106 W Winchester St # 50, Murray, UT 84107-7713 | 2020-11-02 |
| 1740880012 | Castle Arch, LLC | Durable Medical Equipment & Medical Supplies | 596 W 750 S # 310c, Bountiful, UT 84010-7268 | 2020-10-27 |
| 1235736059 | Uintah Basin Medical Center | Durable Medical Equipment & Medical Supplies | 625 W 500 N, Vernal, UT 84078-8319 | 2020-10-05 |
| 1700483567 | Cranio Ninja LLC | Durable Medical Equipment & Medical Supplies | 975 N Main St Ste 3a, Layton, UT 84041-2200 | 2020-10-05 |
| 1861009052 | Appy Medical, LLC | Durable Medical Equipment & Medical Supplies | 8789 South Redwood Road Bld 4, Ste 250, West Jordan, UT 84088-5748 | 2020-09-30 |
| 1942815014 | Matthew Rumsey | Durable Medical Equipment & Medical Supplies | 869 E 960 S, Salem, UT 84653-5758 | 2020-09-15 |
| 1649885096 | Wound Pros Utah | Durable Medical Equipment & Medical Supplies | 6975 Union Park Avenue, Suite 600, Cottonwood Heights, UT 84047 | 2020-09-12 |
| 1679186837 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5792 South Redwood Road, Taylorsville, UT 84123 | 2020-08-27 |
| 1497381917 | Alpha Medical Supply & Distributing | Durable Medical Equipment & Medical Supplies | 3132 W 7670 S, West Jordan, UT 84084-2867 | 2020-03-16 |
| 1679111405 | Sound Sleep Medical LLC | Durable Medical Equipment & Medical Supplies | 321 E State Rd Ste 1, American Fork, UT 84003-2275 | 2019-12-11 |
| Find all providers with the same taxonomy | ||||
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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.