UINTAH BASIN MEDICAL CENTER (NPI# 1851920151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851920151 |
| Entity Type | Organization |
| Organization Name | UINTAH BASIN MEDICAL CENTER |
| Other Organization Name | UBMC CLINIC |
| Practice Address |
250 W 300 N Roosevelt UT 84066-2336 |
| Practice Telephone | 4357257448 |
| Practice Fax Number | 4357229291 |
| Mailing Telephone | 4357257448 |
| Mailing Fax Number | 4357229291 |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2020-07-01 |
| Authorized Official Name | JAMES MARSHALL (CEO) |
| Authorized Official Telephone | 4357257448 |
| Is Organization Subpart | Y |
| Parent Organization Name | UINTAH BASIN MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| UBMC Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736059 | Uintah Basin Medical Center | Durable Medical Equipment & Medical Supplies | 625 W 500 N, Vernal, UT 84078-8319 | 2020-10-05 |
| 1679193338 | Uintah Basin Medical Center | Clinic/Center | 50 S 200 E, Duchesne, UT 84021 | 2020-04-23 |
| 1629034376 | Uintah Basin Medical Center | Hospice Care, Community Based | 26 W 200 N, Roosevelt, UT 84066-2329 | 2006-04-21 |
| 1063651669 | Uintah Basin Medical Center | Pharmacy | 50 East 200 South, Duchesne, UT 84021 | 2009-02-05 |
| Street Address |
250 W 300 N |
| City | ROOSEVELT |
| State | UT |
| Zip Code | 84066-2336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134106784 | Clayton Scott Syndergaard | Obstetrics & Gynecology | 250 W 300 N, Ubmc, Roosevelt, UT 84066-2336 | 2005-12-26 |
| 1346875325 | Shalese Marie Killian | Registered Nurse | 250 W 300 N, Roosevelt, UT 84066-2336 | 2020-03-10 |
| 1609413871 | Timothy James Hughes | Physical Therapist | 250 W 300 N, Roosevelt, UT 84066-2336 | 2019-12-05 |
| 1154974657 | Tanya Sarah Boren | Nurse Practitioner | 250 W 300 N, Roosevelt, UT 84066-2336 | 2019-07-23 |
| 1194292920 | Katie Beutler Ralon | Physician Assistant | 250 W 300 N, Roosevelt, UT 84066-2336 | 2018-10-30 |
| 1154854313 | Nicole Uresk Glines | Pharmacist | 250 W 300 N, Roosevelt, UT 84066-2336 | 2017-04-05 |
| 1699225730 | Christina Thacker | Nurse Practitioner | 250 W 300 N, Roosevelt, UT 84066-2336 | 2016-10-13 |
| 1518417054 | Audrie Christine Wisell | Nurse Practitioner | 250 W 300 N, Roosevelt, UT 84066-2336 | 2016-10-07 |
| 1154876480 | Landon Mathews | Pharmacist | 250 W 300 N, Roosevelt, UT 84066-2336 | 2016-08-16 |
| 1316316482 | Northeastern Utah Medical Group | Physician Assistant | 250 W 300 N, Roosevelt, UT 84066-2336 | 2015-09-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477075315 | Annemarie Rousseau | Registered Nurse | 250 West 300 North, Roosevelt, UT 84066 | 2017-07-12 |
| 1780036772 | Drew Gilley | Dentist | 375 E Lagoon St, Roosevelt, Ut 84066, Roosevelt, UT 84066 | 2016-07-01 |
| 1952758039 | Amanda Adams | Massage Therapist | 1151 East Hwy 40, Ballard, UT 84066 | 2016-05-19 |
| 1447624325 | Gregory George Page | Dentist | 209 West 200 North 71-2, Roosevelt, UT 84066 | 2015-11-16 |
| 1659785772 | Becky Ann Birch | Nurse Practitioner | 200 West 350 North, Ste 103, Roosevelt, UT 84066 | 2014-06-17 |
| 1760724280 | Novo Ranch LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3549 W 1000 North, Roosevelt, UT 84066 | 2013-03-22 |
| 1508110040 | Uintah Basin Spine and Disc Center, PC | Rehabilitation Unit | 1151 East Highway 40, Roosevelt, UT 84066 | 2012-11-06 |
| 1184918682 | Alvaro Beltran | Dentist | Ave. Lopez Mateos 171-4, Nogales, SONORA 84066 | 2011-06-02 |
| 1255638367 | Cosme Cantu | Dentist | Blvd. El Greco #45 Int. J-14, Nogales, SONORA 84066 | 2011-02-25 |
| 1740482009 | Northeastern Utah Medical Group | Durable Medical Equipment & Medical Supplies | 210 W 300 N 75 3, Roosevelt, UT 84066 | 2007-05-31 |
| Find all providers in zip 84066 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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|---|---|---|---|---|
| 1063028991 | Atlas Epigenetics | Clinic/Center | 3311 N University Ave Ste 150, Provo, UT 84604-7431 | 2020-09-16 |
| 1649882069 | Vasco Healthcare Inc | Clinic/Center | 470 E 3900 S Ste 100, Salt Lake City, UT 84107-2331 | 2020-08-18 |
| 1467082644 | Treatment Network LLC | Clinic/Center | 12608 S 125 W Ste B2, Draper, UT 84020-5443 | 2020-01-16 |
| 1750928214 | Kyunghee Seo K Mental Health Clinic | Clinic/Center | 1160 S State St Ste 160a, Orem, UT 84097-8263 | 2019-12-04 |
| 1740836345 | The Lift Clinic, LLC | Clinic/Center | 345 W 100 S # 6c, Slc, UT 84101-1209 | 2019-08-11 |
| 1952953101 | Restorative Health Primary Care | Clinic/Center | 850 E 9400 S Ste 101, Sandy, UT 84094-4114 | 2019-07-09 |
| 1063986800 | Healthworks Med Group of Utah P C | Clinic/Center | 4163 S 3200 W, West Valley City, UT 84119-5128 | 2019-01-15 |
| 1235615790 | Community Birth Group | Clinic/Center | 1190 E 5425 S Ste 330, South Ogden, UT 84403-4548 | 2018-07-17 |
| 1275044075 | Edge Medical Services Inc. | Clinic/Center | 959 W Sedge Ct, Farmington, UT 84025-2541 | 2017-10-19 |
| 1992214027 | National Birth Centers, Inc | Clinic/Center | 4345 S Vallejo Dr, Holladay, UT 84124-3756 | 2017-09-20 |
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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.