THE ADDICTION MEDICINE PHYSICIANS GROUP, LLC (NPI# 1790273704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790273704 |
| Entity Type | Organization |
| Organization Name | THE ADDICTION MEDICINE PHYSICIANS GROUP, LLC |
| Practice Address |
9160 S 300 E. Ste 25 Sandy UT 84070 |
| Mailing Address |
9160 S. 300 E Ste 25 Sandy UT 84070 |
| Practice Telephone | 8018598092 |
| Practice Fax Number | 8449659279 |
| Mailing Telephone | 8018598092 |
| Mailing Fax Number | 8449659279 |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2018-04-25 |
| Authorized Official Name | MR. TERRELL LEE SELLERS (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8018598092 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WA0400X |
Registered Nurse Specialization: Addiction (Substance Use Disorder) |
311613-3102 | UT | Nursing Service Providers |
| Y | 207LA0401X |
Anesthesiology Specialization: Addiction Medicine |
293281-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
9160 S 300 E. STE 25 |
| City | SANDY |
| State | UT |
| Zip Code | 84070 |
| 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 |
| 1841794765 | Caryn Beazel | Physical Therapist | 9350 150 E, Sandy, UT 84070 | 2018-03-23 |
| 1033627591 | Kkmmcb Medical, Pllc | Electrodiagnostic Medicine | 9980 South 300 West Suite 200, Sandy, UT 84070 | 2018-01-18 |
| Find all providers in zip 84070 | ||||
| Taxonomy Code | 207LA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Addiction Medicine |
| An anesthesiologist who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023049418 | Daniel Rey Faber | Anesthesiology | 280 River Park Dr, #200, Provo, UT 84604-5764 | 2006-07-05 |
Please comment or provide details below to improve the information on THE ADDICTION MEDICINE PHYSICIANS GROUP, LLC.
| 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.