Wasatch Senior and Family Care LLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

WASATCH SENIOR AND FAMILY CARE LLC

Practice address

544 E 1200 S
Heber City, UT 84032-4497

Phone

(435) 400-1051

NPI assigned

Sep 17, 2019

Last updated

Oct 14, 2022By 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

Michael James Farrell IV, DONPI 1619264397

Title

Sole Member

Phone

(435) 400-1051

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, CA2 enrollments

Enrollment records 2

Locations

Practitioners 1

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.

• Michael J. Farrell IV, D.O.

  • Geriatric Medicine (Internal Medicine) Physician
  • Heber City, UT
  • NPI 1619264397

  CA

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1255981643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "801-294-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 E 1200 S",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840324497",
            "telephone_number": "435-400-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASATCH SENIOR AND FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-17",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "435-400-1051",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wasatch Crest Recovery
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• Wasatch Optimal Wellness Clinic LLC (WOW Clinic)
• Wasatch Physical Therapy Co
• Wasatch TMS LLC (Heber Mental Health)
• Jordan Washburn
• Christy Anne Watt, RDN
• Amy Michelle Watts, ACMHC
• Dawn Heather Watts, LCSW

• Geriatric Medicine (Internal Medicine) Physician in Heber City, UT
• Providers in Heber City, UT by specialty
• Geriatric Medicine (Internal Medicine) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.