Wasatch Functional Medicine

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

WASATCH FUNCTIONAL MEDICINE

Doing business as

Wasatch Functional Medicine

Practice address

5711 S 1475 E Ste 201
South Ogden, UT 84403-5185

Phone

(801) 332-9034

NPI assigned

Feb 8, 2022

Organization subpart

No

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

Authorized official

Name

Catherine Kelly Pierce, FNP-C

Title

Owner/Nurse Practitioner

Phone

(801) 332-9034

Specialties & licenses 2

Addresses

Other names 1

• Wasatch Functional Medicine Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Catherine Kelly Peterson, FNP-C

  • Family Nurse Practitioner
  • South Ogden, UT
  • NPI 1750842381
  NPD
• Shaylee C Pettit, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • South Ogden, UT
  • NPI 1215679931
  NPD

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1396499414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5711 S 1475 E STE 201",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844035185",
            "telephone_number": "801-332-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5711 S 1475 E STE 201",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844035185",
            "telephone_number": "801-332-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASATCH FUNCTIONAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "KELLY",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "801-332-9034",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wasatch Functional Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Walmart Inc.
• Kimberly Ruth Walsh, PSY.D.
• David J. Ward, LCSW
• Wasatch Foot & Ankle Institute LLC
• Wasatch Foot & Ankle Institute, LLC
• Wasatch Home Health & Hospice, LLC
• Wasatch Mountains Home Care LLC
• Webb Physical Therapy Inc.
• Brent Webb
• Wellnest Medical PC

• Clinic/Center in South Ogden, UT
• Providers in South Ogden, UT by specialty
• Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.