Intermountain Medical Monitoring LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

6049595-1204 Issued in UT

Legal business name

INTERMOUNTAIN MEDICAL MONITORING LLC

Practice address

1306 Deer Crest
Fruit Heights, UT 84037

Phone

(801) 755-4509

Fax

(801) 593-9848

NPI assigned

Oct 21, 2010

Last updated

Nov 10, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Darin S Stettler, D.O.

Title

Owner/Manager/Board Member

Phone

(801) 755-4509

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1134429384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 DEERCREST",
            "city": "FRUIT HEIGHTS",
            "state": "UT",
            "postal_code": "84037",
            "telephone_number": "801-755-4509",
            "fax_number": "801-593-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 DEER CREST",
            "city": "FRUIT HEIGHTS",
            "state": "UT",
            "postal_code": "84037",
            "telephone_number": "801-755-4509",
            "fax_number": "801-593-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN MEDICAL MONITORING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-21",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "STETTLER",
        "authorized_official_first_name": "DARIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/MANAGER/BOARD MEMBER",
        "authorized_official_telephone_number": "801-755-4509",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "UT",
            "license": "6049595-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Anesthesiology) Physician in Fruit Heights, UT
• Providers in Fruit Heights, UT by specialty
• Pain Medicine (Anesthesiology) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.