NPIMap

Organization Active NPI

Wow Medical LLC

Doing business as Wasatch Family and Women's Health

  • Family Medicine Physician
  • Heber City, UT
National Provider Identifier
1356913537
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WOW MEDICAL LLC
Doing business as
Wasatch Family and Women's Health
Practice address
345 E Gateway Dr Ste 150
Heber City, UT 84032-4625
Phone
(435) 657-0101
NPI assigned
Jul 15, 2021
Last updated
Jul 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
Isaac Button
Title
Manager
Phone
(480) 359-3129

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

345 E Gateway Dr Ste 150
Heber City, UT 84032-4625

Mailing address

160 W Canyon Crest Rd
Alpine, UT 84004-1679
Phone (480) 359-3120

Other names 1

  • Wasatch Family and Women's Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211101000305 UT Part B Supplier - Clinic/Group Practice 5991193526 Receives reassigned benefits from 6 practitioners
Practice locations: Heber City, UT

National Provider Directory

National Provider Directory

Locations

150 N Main St
Ste 105
Heber City, UT 84032
Phone (435) 654-1377

345 E Gateway Dr
Ste 150
Heber City, UT 84032
Phone (435) 657-0101

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1356913537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 W CANYON CREST RD",
            "city": "ALPINE",
            "state": "UT",
            "postal_code": "840041679",
            "telephone_number": "480-359-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 E GATEWAY DR STE 150",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840324625",
            "telephone_number": "435-657-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOW MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "BUTTON",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-359-3129"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wasatch Family and Women's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Heber City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.