NPIMap

Organization Active NPI

Advanced Health Clinic

  • Specialist
  • Farmington, UT
National Provider Identifier
1386863108
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ADVANCED HEALTH CLINIC
Practice address
630 Shepard LN
Farmington, UT 84025-3934
Phone
(801) 447-8680
Fax
(801) 447-4211
NPI assigned
Apr 24, 2007
Last updated
Jul 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Authorized official

Name
Lisa A Larson, L.M.T.NPI 1447479225
Title
Office Manager
Phone
(801) 447-8680

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

630 Shepard LN
Farmington, UT 84025-3934

Mailing address

630 Shepard LN
Farmington, UT 84025-3934
Phone (801) 447-8680

National Provider Directory

National Provider Directory

Locations

630 Shepard Ln
Farmington, UT 84025
Phone (801) 447-8680

Practitioners & affiliated clinicians

Practitioners 10

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": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248220800000",
    "number": "1386863108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 SHEPARD LN",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840253934",
            "telephone_number": "801-447-8680",
            "fax_number": "801-447-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 SHEPARD LN",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840253934",
            "telephone_number": "801-447-8680",
            "fax_number": "801-447-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2009-07-22",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-447-8680",
        "authorized_official_credential": "L.M.T."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.