SAMUEL JOHN KOZLOFF (NPI# 1821521337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821521337 |
| Entity Type | Individual |
| Full Name | SAMUEL JOHN KOZLOFF |
| Credential | M.D. |
| Practice Address |
630 Medical Dr Bountiful UT 84010-4908 |
| Mailing Address |
550 1st Ave New York NY 10016-6402 |
| Practice Telephone | 7752041400 |
| Mailing Telephone | 2122635506 |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2020-10-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 11942247-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | NY | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 550 1st Ave, New York, NY 100166402 | 2122635506 |
| Street Address |
630 MEDICAL DR |
| City | BOUNTIFUL |
| State | UT |
| Zip Code | 84010-4908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144201120 | Richard N Hartvigsen | Radiology | 630 Medical Dr, Bountiful, UT 84010-4908 | 2005-11-08 |
| 1932665239 | Stephanie Lynn Blundell | General Acute Care Hospital | 630 Medical Dr, Bountiful, UT 84010-4908 | 2019-02-12 |
| 1205308780 | Janice Trump | Nurse Practitioner | 630 Medical Dr, Bountiful, UT 84010-4908 | 2018-12-21 |
| 1619379971 | Selma Hercinovic | Social Worker | 630 Medical Dr, Bountiful, UT 84010-4908 | 2014-09-18 |
| 1952720633 | Alex G. Drake | Emergency Medicine | 630 Medical Dr, Bountiful, UT 84010-4908 | 2014-04-10 |
| 1518383546 | Greg Mendiola | Pharmacist | 630 Medical Dr, Bountiful, UT 84010-4908 | 2014-03-14 |
| 1396186409 | Karine Julie Hachon | Nurse Anesthetist, Certified Registered | 630 Medical Dr, Bountiful, UT 84010-4908 | 2013-07-17 |
| 1295071694 | Mountainstar Behavioral Health LLC | Behavioral Analyst | 630 Medical Dr, Bountiful, UT 84010-4908 | 2012-12-13 |
| 1174868525 | Mountainstar Behavioral Health LLC | Psychiatry & Neurology | 630 Medical Dr, Bountiful, UT 84010-4908 | 2012-12-11 |
| 1801168794 | Bountiful Ridge Anesthesia, Pllc | Nurse Anesthetist, Certified Registered | 630 Medical Dr, Bountiful, UT 84010-4908 | 2012-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225699192 | Jessyca K Willie | Behavior Technician | 415 S. Medical Drive Suite D101, Bountiful, UT 84010 | 2019-06-21 |
| 1336634344 | Shanna Joy Jaggers | Social Worker | 2333 S 200 E, Bountiful, UT 84010 | 2018-06-22 |
| 1447773171 | Live Life Alarms | Emergency Response System Companies | 640 South 500 West, Bountiful, UT 84010 | 2017-07-25 |
| 1902328842 | Hailey Embley | Behavior Technician | 415 Medical Drive D 101, Bountiful, UT 84010 | 2017-07-12 |
| 1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
| 1295287720 | Samantha Oslund | Speech-Language Pathologist | 415 Medical Dr Ste B102, Bountiful, UT 84010 | 2016-11-01 |
| 1750748273 | Jeremy Clark Morris | Dentist | 59 W 1600 N, Suite 110, Bountiful, UT 84010 | 2016-01-28 |
| 1629464706 | Shane James | Speech-Language Pathologist | 425 Medical Dr Ste 122, Bountiful, UT 84010 | 2015-04-15 |
| 1891186102 | Kenton Francis | Social Worker | 1355 North Main Street #1, Bountiful, UT 84010 | 2015-02-09 |
| 1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
| Find all providers in zip 84010 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104229665 | Eln Enterprises | Internal Medicine | 1480 Orchard Dr Ste 103, Bountiful, UT 84010-5172 | 2014-09-29 |
| 1396037206 | Kc Medical Enterprise Pllc | Internal Medicine | 415 South Medical Dr Ste C201, Bountiful, UT 84010-4946 | 2011-05-11 |
| 1871885111 | Regina W. Drueding, M.d. PC | Internal Medicine | 415 Medical Dr Ste D201, Bountiful, UT 84010-4983 | 2011-05-04 |
| 1821304783 | Kaname Kay Okawa | Internal Medicine | 1299 E Millbrook Way, Bountiful, UT 84010-2054 | 2010-08-28 |
| 1407956121 | Bryan R. Bartholomew | Internal Medicine | 520 Medical Dr Ste 200, Bountiful, UT 84010 | 2006-09-23 |
| 1710996707 | Joseph D. Jensen | Internal Medicine | 520 Medical Dr Ste 300, Bountiful, UT 84010-8925 | 2006-08-07 |
| 1568451730 | Russell Brent Shields | Internal Medicine | 425 N Medical Dr, Ste 108, Bountiful, UT 84010 | 2005-10-19 |
| 1184125668 | Joshua Oaks Md Pllc | Internal Medicine | 520 Medical Dr Ste 300, Bountiful, UT 84010-8925 | 2018-02-21 |
| 1407242993 | Allan C Edson, D.o., PC | Internal Medicine | 425 Medical Dr, Suite 207, Bountiful, UT 84010-4945 | 2015-04-10 |
| 1205221405 | Joshua Brad Oaks | Internal Medicine | 520 Medical Dr Ste 300, Bountiful, UT 84010-8925 | 2015-04-03 |
| Find all providers in BOUNTIFUL | ||||
Please comment or provide details below to improve the information on SAMUEL JOHN KOZLOFF.
| 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.