WELLCON, INC. (NPI# 1750989349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750989349 |
| Entity Type | Organization |
| Organization Name | WELLCON, INC. |
| Practice Address |
3415 S 900 W South Salt Lake UT 84119-4103 |
| Mailing Address |
2263 E Cottonwood Cir Salt Lake City UT 84117-7601 |
| Practice Telephone | 8019183692 |
| Mailing Telephone | 8019183692 |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |
| Authorized Official Name | DR. TODD R WILCOX (CEO) |
| Authorized Official Telephone | 8019183692 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084F0202X |
Psychiatry & Neurology Specialization: Forensic Psychiatry |
Allopathic & Osteopathic Physicians |
| Street Address |
3415 S 900 W |
| City | SOUTH SALT LAKE |
| State | UT |
| Zip Code | 84119-4103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861428856 | Todd R Wilcox | Emergency Medicine | 3415 S 900 W, South Salt Lake, UT 84119-4103 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164981932 | Arches Home Care, Inc. | Non-emergency Medical Transport (VAN) | 1385 W 2200 S Ste 203, West Valley City, UT 84119 | 2019-03-19 |
| 1629591003 | Exemplar Healthcare, Inc. | Hospice Care, Community Based | 1385 W 2200 S Ste 202, West Valley City, UT 84119 | 2017-07-18 |
| 1619358496 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 2875 S Decker Lake Dr Ste 180, West Valley City, UT 84119 | 2015-06-17 |
| 1821407735 | Nathan William Stobbe | Dentist | 3280 W. 3500 S. Ste 3, West Valley, UT 84119 | 2014-08-05 |
| 1801209028 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3148 W 3500 S, West Valley City, UT 84119 | 2014-06-05 |
| 1215347935 | Karl Edward Jennings | Social Worker | 3901 S David Pl, West Valley City, UT 84119 | 2014-05-02 |
| 1750624672 | Shannon Quinn Dunlop | Registered Nurse | 2621 S 3270 W, West Valley City, UT 84119 | 2013-03-28 |
| 1215273529 | Holly H Tanski | Counselor | 5770 S. 1500 W. Bld A, Ihc Wasatch Canyons Campus, Salt Lake City, UT 84119 | 2012-12-14 |
| 1982955860 | Oquirrh Meadows Care and Rehab, Inc | Assisted Living Facility | 2948 So. Redwood Road, West Valley City, UT 84119 | 2012-10-02 |
| 1518235068 | Asjad Kaleem Mohammed | Pharmacist | 2290 S Redwood Road, Olive Pharmacy, Salt Lake City, UT 84119 | 2011-12-12 |
| Find all providers in zip 84119 | ||||
| Taxonomy Code | 2084F0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Forensic Psychiatry |
| Forensic Psychiatry is a subspecialty with psychiatric focus on interrelationships with civil, criminal and administrative law, evaluation and specialized treatment of individuals involved with the legal system, incarcerated in jails, prisons, and forensic psychiatry hospitals. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558430470 | Phil Washburn | Psychiatry & Neurology | 251 W Hwy 198, Salem, UT 84653-0786 | 2006-11-07 |
| 1558332353 | David L Moulton | Psychiatry & Neurology | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2006-01-30 |
| 1548244676 | Poonam Soni | Psychiatry & Neurology | 3970 S 700 E Ste 12, Salt Lake City, UT 84107-2584 | 2005-12-01 |
| 1841310950 | Benjamin Todd Thatcher | Psychiatry & Neurology | 1020 S Main St, #300, Salt Lake City, UT 84101-3176 | 2007-03-30 |
| 1780731679 | Aaron James Hunt | Psychiatry & Neurology | 1300 E Center St, Provo, UT 84606-3554 | 2007-01-04 |
| 1639269269 | David A. Tomb | Psychiatry & Neurology | 50 N Medical Dr, Salt Lake City, UT 84132 | 2006-10-13 |
| 1174546337 | Trent C. Holmberg | Psychiatry & Neurology | 12176 S 1000 E, Suite B, Draper, UT 84020-9734 | 2006-07-26 |
| 1568483030 | Joseph D Dye | Psychiatry & Neurology | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2006-07-21 |
| 1013995471 | Edward Leslie Kelly | Psychiatry & Neurology | 1300 E Center St, Provo, UT 84606-3554 | 2006-01-05 |
| City | SOUTH SALT LAKE |
| Zip Code | 84119 |
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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.