NPIMap

Organization Active NPI

Metamorphosis Ogden, Inc.

  • Methadone Clinic
  • Ogden, UT
National Provider Identifier
1295804110
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
6264391-8913 Issued in UT
Legal business name
METAMORPHOSIS OGDEN, INC.
Practice address
2144 Washington Blvd
Ogden, UT 84401-1420
Phone
(801) 622-5272
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Authorized official

Name
Ms. Shannon M. Terwedo, M.P.A., FACHE
Title
President
Phone
(801) 622-5272

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X 6264391-8913 UT Primary

Addresses

Primary practice location

2144 Washington Blvd
Ogden, UT 84401-1420

Mailing address

2557 Lincoln Avenue
Ogden, UT 84401
Phone (801) 622-5272

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1295804110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2557 LINCOLN AVENUE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "84401",
            "telephone_number": "801-622-5272",
            "fax_number": "801-622-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2144 WASHINGTON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844011420",
            "telephone_number": "801-622-5272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METAMORPHOSIS OGDEN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2015-08-06",
        "status": "A",
        "authorized_official_last_name": "TERWEDO",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-622-5272",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.P.A., FACHE"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "UT",
            "license": "6264391-8913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; 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.