Active NPI
Monica Child Wonnacott, M.D.
- Pediatrics Physician
- Riverton, UT
National Provider Identifier
1003029935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 66196611205
- Practice address
- 12391 S 4000 W
Riverton, UT 84096-7012 - Phone
- (801) 302-1700
- Fax
- (801) 302-1714
- NPI assigned
- May 7, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 5069 | NE | |
| Pediatrics Physician | 208000000X | 66196611205 | UT | Primary |
Addresses
Primary practice location
12391 S 4000 W
Riverton, UT 84096-7012
Mailing address
12391 S 4000 W
Riverton, UT 84096-7012
Phone (801) 302-1700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5069 | NE | MD | Mental Health Counselor |
| 66196611205 | UT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Granger Medical Specialists LLC | Past | Accepting new patients | |
| Granger Medical Clinic PC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- monica.wonnacott@gmcwv.eclinicaldirectplus.com
- https://fhir4.healow.com/fhir/r4/HGCCCA/Endpoint/HGCCCA
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- West Valley City, UT
- NPI 1184657041
Pediatrics
-
- Clinic/Center
- West Valley City, UT
- NPI 1376159368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368403200000",
"number": "1003029935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12391 S 4000 W",
"city": "RIVERTON",
"state": "UT",
"postal_code": "840967012",
"telephone_number": "801-302-1700",
"fax_number": "801-302-1714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12391 S 4000 W",
"city": "RIVERTON",
"state": "UT",
"postal_code": "840967012",
"telephone_number": "801-302-1700",
"fax_number": "801-302-1714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONNACOTT",
"first_name": "MONICA",
"middle_name": "CHILD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-07",
"last_updated": "2013-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NE",
"license": "5069",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "UT",
"license": "66196611205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.