NPIMap

Organization Active NPI

Comprehensive Medical Management, PC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • West Valley City, UT
National Provider Identifier
1104060714
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
89180152-1205 Issued in UT
Legal business name
COMPREHENSIVE MEDICAL MANAGEMENT, PC
Practice address
4052 W Pioneer Parkway
Suite 208
West Valley City, UT 84120
Phone
(801) 955-1232
Fax
(801) 955-1543
NPI assigned
Apr 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Timothy Grange, MD
Title
Owner
Phone
(801) 955-1232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X 89180152-1205 UT Primary

Addresses

Primary practice location

4052 W Pioneer Parkway
Suite 208
West Valley City, UT 84120

Mailing address

4052 W Pioneer Parkway
Suite 208
West Valley City, UT 84120
Phone (801) 955-1232

Other names 1

  • The Spine, Orthopedic and Pain Center Doing business as

National Provider Directory

National Provider Directory

Locations

4052 W Pioneer Pkwy
Ste 20
West Valley City, UT 84120
Phone (801) 955-1232

4052 W Pioneer Pkwy
Ste 208
West Valley City, UT 84120
Phone (801) 955-1232

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246838400000",
    "number": "1104060714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4052 W PIONEER PARKWAY",
            "address_2": "SUITE 208",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "84120",
            "telephone_number": "801-955-1232",
            "fax_number": "801-955-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4052 W PIONEER PARKWAY",
            "address_2": "SUITE 208",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "84120",
            "telephone_number": "801-955-1232",
            "fax_number": "801-955-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE MEDICAL MANAGEMENT, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-27",
        "last_updated": "2009-07-06",
        "status": "A",
        "authorized_official_last_name": "GRANGE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-955-1232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "UT",
            "license": "89180152-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Spine, Orthopedic and Pain Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Valley City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.