MEDICAL DIRECTOR SERVICES, LLC (NPI# 1770751323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770751323 |
| Entity Type | Organization |
| Organization Name | MEDICAL DIRECTOR SERVICES, LLC |
| Practice Address |
50 E 9000 S Sandy UT 84070-2201 |
| Mailing Address |
Po Box 71840 Salt Lake City UT 84171-0840 |
| Practice Telephone | 8015619839 |
| Mailing Telephone | 8018099471 |
| Mailing Fax Number | 8015721497 |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2008-04-17 |
| Authorized Official Name | KAVITA G WILLESEN (PRESIDENT/PHYSICIAN) |
| Authorized Official Telephone | 8018099471 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 5049379-1205 | UT | Other Service Providers |
| Street Address |
50 E 9000 S |
| City | SANDY |
| State | UT |
| Zip Code | 84070-2201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508865825 | Sandy Regional, Inc. | Skilled Nursing Facility | 50 E 9000 S, Sandy, UT 84070-2201 | 2005-07-19 |
| 1770876468 | Brian James Terry | Clinic/Center | 50 E 9000 S, Sandy, UT 84070-2201 | 2011-05-27 |
| 1447561733 | Darin Anthony Bouwhuis | Occupational Therapist | 50 E 9000 S, Sandy, UT 84070-2201 | 2010-07-01 |
| 1417083064 | Derek Omar White | Physical Therapist | 50 E 9000 S, Sandy, UT 84070-2201 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639777568 | Megan Komatsu Inc. | Social Worker | 10815 700 East, Sandy, UT 84070 | 2020-10-13 |
| 1841803137 | Anywhere Care | Nurse Practitioner | 9980 S. 300 W. Suite 200, Sandy, UT 84070 | 2020-08-26 |
| 1245840552 | Kirandeep Kaur | Psychologist | 9678 700 E # 102, Sandy, UT 84070 | 2020-08-03 |
| 1740890961 | Elizabeth Lowe Madsen | Counselor | 9678 700 East Suite 102, Sandy, UT 84070 | 2020-08-03 |
| 1417597188 | Hayley Burr | Counselor | 8706 700 E, Suite 205, Sandy, UT 84070 | 2020-01-10 |
| 1821656422 | Karen Ritchie | Counselor | 9192 South 300 West, Sandy, UT 84070 | 2019-05-30 |
| 1679068159 | Derek Livingston | Counselor | 11075 State St #35, Sandy, UT 84070 | 2018-06-27 |
| 1891283735 | Alta Rx LLC. | Pharmacy | 9883 South 500 West, Sandy, UT 84070 | 2018-04-26 |
| 1790273704 | The Addiction Medicine Physicians Group, LLC | Registered Nurse | 9160 S 300 E. Ste 25, Sandy, UT 84070 | 2018-04-25 |
| 1841794765 | Caryn Beazel | Physical Therapist | 9350 150 E, Sandy, UT 84070 | 2018-03-23 |
| Find all providers in zip 84070 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477112464 | Protectus Wound Care | Specialist | 4 Ravenwood Ln, Sandy, UT 84092-4849 | 2019-06-12 |
| 1164852224 | John Librett | Specialist | 1151 E Castle Rock Rd, Sandy, UT 84094-5688 | 2013-11-26 |
| 1568803773 | Russell L. Sorensen LLC | Specialist | 9844 S 1300 E Ste 250, Sandy, UT 84094-4691 | 2013-07-16 |
| 1285971697 | Robert W Later Md PC | Specialist | 9600 S 1300 E Suite 302, Sandy, UT 84094 | 2013-01-07 |
| 1053628214 | Melissa Knowles | Specialist | 37640 Green Mountain St, Sandy, OR 97055-6366 | 2010-09-09 |
| 1457670713 | Darrin F Hansen M.d. P.C. | Specialist | 9720 S 1300 E Ste W110, Sandy, UT 84094-3765 | 2010-05-26 |
| 1649424888 | Reproductive Care Associates | Specialist | 10150 Petrunia Way, Sandy, UT 84092-4380 | 2008-11-14 |
| 1558521385 | Gary F Larsen | Specialist | 7610 Caballero Dr, Sandy, UT 84093-6238 | 2008-06-16 |
| 1962475350 | Keith L. Blauer | Specialist | 10150 Petunia Way, Sandy, UT 84092-4380 | 2006-02-08 |
| 1922091230 | Charles Darrell Katz | Specialist | 9450 S 1300 E, Sandy, UT 84094-5555 | 2005-08-23 |
| Find all providers in SANDY | ||||
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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.