Modern Medical Injury Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MODERN MEDICAL INJURY CLINIC LLC

Practice address

640 E 700 S Ste 103
St George, UT 84770-5731

Phone

(354) 652-2850

NPI assigned

Jan 16, 2023

Organization subpart

No

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

Authorized official

Name

Aj Yergensen

Title

Admin

Phone

(435) 986-9369

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1346955150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 E 700 S STE 103",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847705731",
            "telephone_number": "354-652-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E 700 S STE 103",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847705731",
            "telephone_number": "354-652-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN MEDICAL INJURY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "YERGENSEN",
        "authorized_official_first_name": "AJ",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "435-986-9369"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regan Mitton
• John Hideo Mizukawa II, DDS
• John Hideo Mizukawa, D.D.S.
• Quamell Jafaar Mobley
• Moderm Medical Solutions Ut PLLC
• Lorraine Gail Moe
• Moenkopi Counseling PC
• Scott G Moesinger, M.D.
• Andrew Collin Moffitt
• Kori Moffitt

• Clinic/Center in St George, UT
• Providers in St George, UT by specialty
• Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.