Intermountain Healthcare

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

8207030-4810 Issued in UT

Legal business name

INTERMOUNTAIN HEALTHCARE

Practice address

652 S Medical Center Dr
Suite 120
St George, UT 84790-7049

Phone

(435) 251-3600

Fax

(435) 628-4469

NPI assigned

Dec 18, 2014

Last updated

Dec 18, 2014By 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

Jennifer Lee Terry, ATC

Title

Athletic Trainer

Phone

(435) 251-3600

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1427456797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 S MEDICAL CENTER DR",
            "address_2": "SUITE 120",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907049",
            "telephone_number": "435-251-3600",
            "fax_number": "435-628-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 S MEDICAL CENTER DR",
            "address_2": "SUITE 120",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907049",
            "telephone_number": "435-251-3600",
            "fax_number": "435-628-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "ATHLETIC TRAINER",
        "authorized_official_telephone_number": "435-251-3600",
        "authorized_official_credential": "ATC"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "UT",
            "license": "8207030-4810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrated Senior Care Hospice (Peak Hospice)
• Integrated Senior Care Personal Care
• Integrated TMS LLC
• Intermountain Audiology Inc.
• Intermountain Dentures PLLC (Smiles Restored)
• Madison McKae Ioane, BEHAVIOR TECHNICIAN
• Iom Professionals
• Andrea Renae Ionel
• Ann A Iroz, LCSW
• Matthew Irvin, D.O.

• Sports Medicine (Orthopaedic Surgery) Physician in St George, UT
• Providers in St George, UT by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.