NPIMap

Organization Active NPI

Therapeutic Wellness Center

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • South Ogden, UT
National Provider Identifier
1174858823
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
License
7487072-0161 Issued in UT
Legal business name
THERAPEUTIC WELLNESS CENTER
Practice address
5974 Fashion Point Dr
Suite 100
South Ogden, UT 84403-4699
Phone
(801) 479-9644
Fax
(801) 479-9639
NPI assigned
Oct 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Authorized official

Name
Dawn Fielding
Title
Executive Director
Phone
(801) 479-9644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X 7487072-0161 UT Primary

Addresses

Primary practice location

5974 Fashion Point Dr
Suite 100
South Ogden, UT 84403-4699

Mailing address

5974 Fashion Point Dr
Suite 100
South Ogden, UT 84403-4699
Phone (801) 479-9644

Other identifiers 1

IdentifierTypeStateIssuer
U000072054OtherUTMEDICARE PTAN

Other names 1

  • Paragon Healthcare of Utah, LLC Former legal business name

National Provider Directory

National Provider Directory

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": "1255478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338422400000",
    "number": "1174858823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5974 FASHION POINT DR",
            "address_2": "SUITE 100",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034699",
            "telephone_number": "801-479-9644",
            "fax_number": "801-479-9639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5974 FASHION POINT DR",
            "address_2": "SUITE 100",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034699",
            "telephone_number": "801-479-9644",
            "fax_number": "801-479-9639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-14",
        "last_updated": "2012-05-31",
        "status": "A",
        "authorized_official_last_name": "FIELDING",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-479-9644"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "UT",
            "license": "7487072-0161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "U000072054",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paragon Healthcare of Utah, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in South Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; 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.