Arizona Integrative Medical

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

ARIZONA INTEGRATIVE MEDICAL

Practice address

14424 S Canvasback LN
Bluffdale, UT 84065-1762

Phone

(801) 580-9690

NPI assigned

Feb 15, 2025

Last updated

Feb 15, 2025By 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

Mrs. Shannon Page Watt

Title

Owner, Ceo

Phone

(801) 580-9690

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1739577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739577600000",
    "number": "1477358356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 E PECOS RD STE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852252438",
            "telephone_number": "801-580-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14424 S CANVASBACK LN",
            "city": "BLUFFDALE",
            "state": "UT",
            "postal_code": "840651762",
            "telephone_number": "801-580-9690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA INTEGRATIVE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-15",
        "last_updated": "2025-02-15",
        "certification_date": "2025-02-15",
        "status": "A",
        "authorized_official_last_name": "WATT",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "PAGE",
        "authorized_official_title_or_position": "OWNER, CEO",
        "authorized_official_telephone_number": "801-580-9690",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Olson CPM Ldem (Peaceful Birth Midwifery)
• Angela Lee Anderson Christensen, D.D.S.
• Kenneth Russell Apgood, AMFT
• Arcadia Recovery Center Professional Limited Liability Company (Arcadia Recovery Center)
• Arcadia Residential Treatment Centers Inc.
• Amber Michelle Artinger
• Asten Aspinall
• Awakening Behavioral Health, LLC (Renaissance Ranch Bluffdale Men's Program, LLC)
• David M Babcock, DMD
• Asenath Barlow, CPM, LDEM

• Physician Assistant in Bluffdale, UT
• Providers in Bluffdale, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2025; 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.