Axon Injury Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

AXON INJURY CLINIC LLC

Practice address

1681 W 3860 S Ste 106B
West Valley City, UT 84119-6274

Phone

(801) 347-5374

NPI assigned

May 3, 2023

Last updated

Jun 2, 2023By 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

Annelyn Sanchez

Title

Owner

Phone

(385) 429-0785

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Blake William Montgomery, PA-C

  • Physician Assistant
  • West Valley, UT
  • NPI 1376223818
  NPD

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1396434544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1681 W 3860 S STE 106B",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841196274",
            "telephone_number": "385-429-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1681 W 3860 S STE 106B",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841196274",
            "telephone_number": "801-347-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXON INJURY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ",
        "authorized_official_first_name": "ANNELYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "385-429-0785"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA-C",
            "identifier": "1477133288",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.