UTAH STATE DEPARTMENT OF CORRECTIONS (NPI# 1770984379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770984379 |
| Entity Type | Organization |
| Organization Name | UTAH STATE DEPARTMENT OF CORRECTIONS |
| Practice Address |
14425 S Bitterbrush Ln Draper UT 84020-9501 |
| Practice Telephone | 8015767292 |
| Mailing Telephone | 8015767292 |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |
| Authorized Official Name | DR. RICHARD GARDEN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8015797099 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2400X |
Clinic/Center Specialization: Prison Health |
9145099-1206 | UT | Ambulatory Health Care Facilities |
| Street Address |
14425 S BITTERBRUSH LN |
| City | DRAPER |
| State | UT |
| Zip Code | 84020-9501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952553794 | Vinessa Kaye Trotter | Psychologist | 14425 S Bitterbrush Ln, Draper, UT 84020-9501 | 2008-10-10 |
| 1578172847 | Leslie Forbush | Nurse Practitioner | 14425 S Bitterbrush Ln, Draper, UT 84020-9501 | 2020-07-23 |
| 1588133185 | Caitlin Jensen | Physician Assistant | 14425 S Bitterbrush Ln, Draper, UT 84020-9501 | 2018-11-13 |
| 1952885568 | Eric Cielinski | Physician Assistant | 14425 S Bitterbrush Ln, Draper, UT 84020-9501 | 2018-09-19 |
| 1235637125 | Michael Shelekhov | Registered Nurse | 14425 S Bitterbrush Ln, Draper, UT 84020 | 2018-01-25 |
| 1932656386 | Todd Gay | Physician Assistant | 14425 S Bitterbrush Ln, Draper, UT 84020-9501 | 2016-09-01 |
| 1972957629 | Rise Curiel | Physician Assistant | 14425 S Bitterbrush Ln, Draper, UT 84020-9501 | 2016-04-19 |
| 1275908840 | Sidney Roberts | Emergency Medicine | 14425 S Bitterbrush Ln, Draper, UT 84020-9501 | 2015-12-08 |
| 1932592110 | Christopher Abbott | Physician Assistant | 14425 S Bitterbrush Ln, Draper, UT 84020-9501 | 2015-03-11 |
| 1225430119 | Jacquelyn Button | Counselor | 14425 S Bitterbrush Ln, Draper, UT 84020-9501 | 2014-09-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
| 1780222380 | Derek Cragun | Counselor | 11706 700 E, Draper, UT 84020 | 2019-12-13 |
| 1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
| 1508418856 | Thomas Mifflin | Physician Assistant | 721 East 12200 South, Draper, UT 84020 | 2019-07-16 |
| 1124670872 | Necia Dalley | Registered Nurse | 11800 S State St, Draper, UT 84020 | 2019-07-12 |
| 1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
| 1275008328 | Amoni Paeahelotu Finau | Community Health Worker | 13703 Wheatfield Way, Draper, UT 84020 | 2018-10-04 |
| 1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
| 1164908026 | Headin' Home Inc. | Community/Behavioral Health | 12300 S. 150 W., Draper, UT 84020 | 2018-07-13 |
| 1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
| Find all providers in zip 84020 | ||||
| Taxonomy Code | 261QP2400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Prison Health |
| Definition to come... |
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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.