Compass Pain Clinic Utah LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

COMPASS PAIN CLINIC UTAH LLC

Practice address

6360 S 3000 E Ste 210
Cottonwood Heights, UT 84121-6972

Phone

(503) 867-5219

NPI assigned

Oct 23, 2024

Last updated

Nov 25, 2024By 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

Daniel Rosenberg

Title

Owner

Phone

(503) 867-5219

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristina Michelle Reed, M.D.

  • Pain Medicine Physician
  • Salt Lake City, UT
  • NPI 1407057953

  Physical Medicine & Rehabilitation

  Medicare reassignment Care Compare group NPD
• Matthew R Peterson, MD

  • Pain Medicine (Anesthesiology) Physician
  • Bellingham, WA
  • NPI 1891785606

  UT

  Medicare reassignment Care Compare group NPD
• Robert Welch, PA-C

  • Physician Assistant
  • Provo, UT
  • NPI 1649743196
  Medicare reassignment
• Jesse Lee McDonald, DACM

  • Acupuncturist
  • Draper, UT
  • NPI 1477361004
  NPD (past)
• Miranda Olsen, DPT

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1528683877
  NPD (past)

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1235950064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 S 3000 E STE 210",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 S 3000 E STE 210",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841216972",
            "telephone_number": "503-867-5219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS PAIN CLINIC UTAH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-867-5219"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen Dwayne Cloar
• Kirsten Cloward
• Connor Cockrell, DDS
• Rebekah Cole
• Maiya Yuriko Coleman
• Amelia Connors
• Angela Cook
• Carla J Cook, LCSW
• Kaylyn Renee Cooper, PA-C
• Brianne Adeana Cordova

• Pain Medicine Physician in Cottonwood Heights, UT
• Providers in Cottonwood Heights, UT by specialty
• Pain Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.